Reducing Covid-19 vaccine disparities among minorities and helping the homeless with Scan Health CEO

Reducing Covid-19 vaccine disparities among minorities and helping the homeless with Scan Health CEO

before the delta surge black and hispanic americans were nearly three times more likely to be hospitalized and twice as likely to die from covid than white americans that’s according to the cdc and while the more infectious delta strain has pushed more minorities to get vaccinated advocates say not enough shots are getting into arms to close the racial gap on new infections and hospitalizations joining me now is dr sachin jain president and ceo of scan health plan we’re also joined by our health reporter anjali kamlani uh thanks to you both for being with us dr jane just i guess bring us up to date on what vaccination rates are like right now among minority communities in this country so so vaccination rates are trending up right now for all communities but at the same time we continue to see persistent gaps between uh african americans and latinx members of our community when you compare them to caucasian members so we as a health plan have made a major focus uh reducing that disparity and over the last uh several months we’ve been able to use a number of different strategies to reduce our disparities across multiple different populations uh including black latinx and low-income members of our health plan uh because we we believe that this is the number one thing we can do to support the health of the patients that we serve dr jane i want to ask you a little bit about another program that i know is near and dear to your heart and that is the efforts on homelessness on one hand we heard the u.s supreme court come down with the decision that the cdc’s eviction moratorium where it’s more or less government overreach and it has to end and it’s consistent with what we’ve seen across the board whether you’re looking at florida or texas and how the courts there have handled mass mandates or rather the bans on some of these mandates so i just wonder if you could parse through that and sort of what this what the implications of this are as you watch the homelessness i think one of the biggest challenges that we have in our society is we’ve mischaracterized homelessness as a housing issue when in fact i do believe it is a health care issue first and foremost i think many people find themselves homeless because of some underlying health care issues whether they be chronic diseases that are untreated mental health issues addiction and we don’t necessarily have a health care system that is particularly good at proactively addressing these issues and as a result many people find themselves untreated and homeless at the same time i think being homeless actually exacerbates underlying chronic disease and illness i think one of the things we have to do is really reframe this issue away from being a housing supply issue and start to think about it more like the health care issue that it is and if you actually redefine how we solve this issue but redefine this issue we’ll it’ll actually change how we think about solving it one of the things that we’ve focused on is building new sustainable payment models that are really that will allow us to actually deliver street-based uh healthcare uh to people who are experiencing homelessness and we think you know in the context of covet-19 in the context of all these regulatory challenges these are the types of solutions that are ultimately going to help address this issue tell me a little bit more about how you’re able to do that because you know if you just look at it at face value your medicare advantage plan why are you getting involved in this and how are you able to basically roll out these programs reimburse for them etc well it really uh goes down to how medicare advantage plans are actually reimbursed for health care services um traditional payment for healthcare is fee for service if you get sick and you land in the hospital um you’ll get paid you’ll the hospital gets reimbursed for the care that is delivered to the patient in medicare advantage many provider groups operate under what’s called prospective payment and so um what we’re doing is wherein you take the total cost of health care the average total cost of health care for a year you give it to a provider group and then that provider group manages all of your care your outpatient care your inpatient care in doing so it creates a much greater incentive towards prevention and that’s why we founded this group healthcare at action which is part of the scan group and a sister entity to scan health plan um is to allow us to do more of the intensive outpatient management that’s less expensive and better for patients um as opposed to paying for costly hospitalizations so it’s really cost shifting away from expensive inpatient care that is oftentimes the side effect of bad outpatient care to investing more heavily in outpatient care for patients you know doctor i just want to get back to the vaccination among minorities issue for a moment and how you know what needs to be done to convince that segment of the population to get the shot do you believe that it’s going to have to come from friends and and leaders within the community and people that that those minority groups trust versus even say science and doctors i think it’s a multi-pronged strategy i think you’re absolutely right i think community leaders have an important role to play in reducing in addressing the misinformation that exists around uh covert vaccinations i think it’s also very important for us to make it as easy as possible one of the things that we did at scan was we partnered with a company called metarive that actually delivers home-based vaccinations to any of our patients who want them and this actually reduces a substantial barrier some people say i’m not necessarily willing to go out there they’re afraid of actually getting vaccinated they’re afraid of actually being in the community we’ve made people afraid of actually leaving their homes and so by actually sending the vaccination into the home in many affected communities um we’re actually able to increase vaccination rates so um i think that’s been an important strategy the other thing is is just making information uh as easily available as possible i think people have multiple sources of information and they don’t know who to trust anymore and um you know one of the things we have as a as a long-standing non-profit trusted health plan in the community is we have that trust with patients and so um we have put ourselves forward as a source of information and uh have a 24 7 vaccine access line and we will go so far as actually scheduling the appointment for the individual which again is another barrier if you’ve actually tried to get vaccinated you know how difficult it sometimes is to use online systems to call a pharmacy there’s oftentimes no one uh available to answer the call for you we’re doing all that hard work for you and so by actually making ourselves that available making making it easier to actually access the vaccination we’re lowering the barriers that many people in low-income communities actually face i want to get your thoughts on something really quickly dr jane and that is just generally the federal government messaging and how two parts so you can choose which part you want to address but on one hand we have reports now that we may have boosters uh five months after recommendations for five months after the initial course but there’s also been you know decision about eight months and then six months and how confusing that might be and what you have to do to get through that simultaneously we’re looking at you know going back to the florida and texas the the idea of mandates coming from guidance in most of the rest of the country and then you have sort of state level uh politicians deciding against that and and in fact taking just as hard as stance against that how do you how do you manage all of that yeah so i you know having served in government i have a lot of compassion for um people who are forced to make uh a lot of communicate a lot of messages with imperfect information and that is what this pandemic has been it’s been an effort in kind of mass communications with imperfect information that’s changing on a daily basis i think we have to have a lot of um i think tolerance for new information and tolerance for changes in that information i think sometimes the whiplash that people feel um is is an unfortunate side effect of changing information but that is the reality of the times that we’re in and so um i think our job as leaders as public health leaders um is to continue to evolve the messaging based on new information and continue to express humility about the information i think one of the challenges that we’ve seen in the public health messaging is people express a level of definitiveness that is inappropriate for the level of information that we have at the time and so i you know every time i talk about this i say well we you know this is the best information we have right now but as information evolves our approach may change and i think that’s been a critical missing piece as we’ve seen too many individuals making too many definitive statements absent you know a full full view of what’s actually happening happening and absent the humility around the evolving science and epidemiology and so again i think my advice to anyone who’s making any kind of public health proclamations at this point whether they’re uh political or you know public health officials uh is to just continue to express that humility i think that humility ultimately builds trust with people um when you are highly definitive and then you change your message a week later in the face of new information that’s when you start to i think amplify the mistrust that many people are feeling right now towards public health officials and government officials all right great insights there dr sachin jain of scan health plan and of course our health reporter anjali kamlani thanks so much
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Reducing Covid-19 vaccine disparities among minorities and helping the homeless with Scan Health CEO

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