Putting Care at the Center, the inaugural conference of the National Center for Complex Health and Social Needs, drew almost 500 stakeholders from across the country— including health care providers, consumers, administrators, researchers, and policymakers— to Philadelphia last week. Declaring their independence from a fragmented health care system that fails the most vulnerable, attendees participated in over three days of plenaries, workshops, and interactive Beehive sessions, and began to build the connections necessary to create a “new way” of health care.
“I think of this room as the Tesla convention— people who want to break things apart and work on the fringes,” said Dr. Toyin Ajayi, Chief Medical Officer of Commonwealth Care Alliance, on the conference’s first plenary on the science of model building. “But we need to take this work from the fringes and make it standard. How do you move this radical and unique approach and make it mainstream? How do we make this the Toyota convention?”
“We need more than 450 people,” agreed her co-panellist Dr. Parinda Khatri, Chief Clinical Officer of Cherokee Health Systems. “We need 450 thousand, 4 million who are willing to do the work. It’s hard work!”
Attendees got to see examples of the work being done across the country during the morning’s workshop sessions. Representatives from the Southcentral Foundation, Health Leads, the National Center for Medical-Legal Partnership, Hennepin Health, the Camden Coalition of Healthcare Providers, and the National Governors Association’s Center for Best Practices presented on their organizations’ models for providing integrated, team-based, and patient-centered care.
At the conference’s second plenary, Hoangmai Pham, Chief Innovation Officer at the Center for Medicare & Medicaid Services, along with Harold Paz, Chief Medical Officer of Aetna, and Allison Silvers, Vice President for Payment and Policy at the Center to Advance Palliative Care, discussed funding as a lever for change in the health care system.
“[There are] tremendous funding challenges to care for these patients,” Camden Coalition CEO Dr. Jeffrey Brenner told the American Journal of Managed Care. “The typical Medicare fee schedule, the way Medicaid is structured, the way commercial insurance is structured, doesn’t provide the flexibility and the team-based structures that you need.”
Trauma was a major theme of the conference. Keynote speaker Geoffrey Canada, President of the Harlem Children’s Zone, and Dr. John Rich, plenary speaker and Director of Drexel University’s Center for Nonviolence and Social Justice, both remarked that for people growing up in violent neighborhoods, there is often no “post” in their post-traumatic stress disorders, just ongoing trauma that affects their health and limits their trajectories.
“We have not constructed trauma-informed structures,” said Dr. Rich. “With the sanctuary model, we have a set of commitments to each other, and a set of practices to [ensure] those commitments”
“When we talk health disparities, we’re talking about devastation that most people have no idea about,” said Geoffrey Canada in his keynote on health equity. “It’s hard to get folks to focus on health when their lives feel so out of control… but hope, like despair, is infectious.”
Attendees got a major cause for hope later that day, when leaders of five major health care foundations unveiled The Playbook: Better Care for People with Complex Needs, an online resource on complex care for health system leaders, policy makers, and payers. Dr. Bruce Chernoff, President and CEO of the SCAN Foundation, described the four questions the playbook is designed to answer: what is the business case for investing in patients with complex health and social needs? How do we identify these populations? What works? And what are the characteristics of success?
“We are all vectors of hope,” said Dr. John Lumpkin, Senior Vice President of the Robert Wood Johnson Foundation. “If we can find a way to meet this challenge for people who have multiple chronic conditions and challenges, we will enable all people who are at risk in the community to live healthier lives.”
The conference ended with a closing panel reflecting on lessons learned. Dr. Ken Coburn, CEO of Health Quality Partners, said the conference had taught him that “the secret of quality is love,” and that “to take that into a practical context is going to take an extraordinary new way of new thinking.”
“We want to do for medicine what Geoffrey Canada did for Harlem,” said Dr. Corey Waller, Senior Medical Director of Education at the Camden Coalition and National Center faculty member. “We need to find all the other people fighting this fight because a lot of us feel like we’re fighting alone.”
Next year’s National Center conference will take place November 15-17 in Los Angeles, hosted by Kaiser Permanente.