State awards nearly $3 million to YoloCares

In a move to expand and deepen the regional safety net for people facing a serious or life-limiting illness, Davis-based YoloCares recently applied for, and secured, a nearly $3 million commitment from the State of California to add an Enhanced Care Management component to its portfolio of offerings.

By design, ECM intends to address the social determinants of health? which are the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age. These dynamics include a wide set of forces and structures that shape daily life such as economic policies and systems, development agendas, social norms, social policies, and political systems.

Addressing SDOH accelerates progress toward health equity ... granting every person the opportunity to attain their highest level of health, regardless of their current situation. SDOH have been shown to have a greater influence on health than either genetic factors or access to healthcare services. For example, poverty is highly correlated with poorer health outcomes and higher risk of premature death. Social determinants of health -- which include the effects from centuries of racism -- are key drivers of health inequities within communities of color. The impact is pervasive and deeply embedded in society, creating inequities in access to a range of social and economic benefits — such as housing, education, wealth, and employment. These inequities put people at higher risk of poor health.

People who do not have access to grocery stores with healthy foods are less likely to have good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity — and even lowers life expectancy relative to people who do have access to healthy foods. Clinical care only has about a 10 to 20 percent impact on a patient’s health outcome. The remaining 80 to 90 percent can be attributed to social determinants of health, which are the socioeconomic and environmental variables that directly affect a person’s lifestyle.

ECM is one of many new statewide Medi-Cal benefits available to eligible members with complex healthcare needs, serious illness, housing insecurity, or recent institutionalization. The program will connect beneficiaries with a single care manager who will coordinate all their health-related care and services. Under this benefit, members will also receive connections to social services, community resources, and programs that will help facilitate healthier, more stable lifestyles.

As Medi-Cal looks towards a major transformation in the structure of benefits, ECM is the Golden State’s initiative to address a lack of palliative and supportive care services. Under the current Medi-Cal model, more than half of program spending is attributed to five percent of members with the highest-cost needs. ECM is designed to address beneficiaries’ healthcare needs before they become life-threatening, thus lowering members’ reliance on emergency medical services and high-cost treatments.

A meaningful benefit of addressing SDOH is that it creates a closer and more informed relationship between patients and their healthcare providers. Clinicians have reported that they are able to understand and treat the full patient, which is what makes delivering health care so rewarding in the first place.

We have learned that if a patient has mental health needs, we must address those alongside their high blood pressure or liver disease. In that process, we may discover that they feel isolated and need to be connected to a community organization that will give them social support. These conversations lead to a deeper, more productive relationship with patients, and that positively impacts their outcomes.

In May, after YoloCares became credentialed as an ECM site by Partnership Health Plan of California, it was awarded $2.6 million to support the development of services for CalAIM, the state’s newly expanded Medi-Cal program, and an additional $300,000 from the Department of Health Care Services’ Technical Assistance Marketplace. In brief, the funding will prepare and position YoloCares to formally act as a service provider for CalAIM beneficiaries by centralizing their care with a lead care manager.

Funding will support the hiring of 17 positions, including clinicians and administrative staff, and technology needs such as laptops and updated electronic medical record software. The grant will also be used to develop organization infrastructure that will, in turn, support patients and families.

According to Lisa Adams, YoloCares’ director of patient access and palliative care, “Our clinical team is adept at responding to the complex and unique needs of our patients and their families, often going above and beyond the scope of typical palliative care to help our patients find comfort and dignity during health challenges and transitions. This funding and recognition from the state simply acknowledges and supports the work we have been doing all along.”

As part of this latest funding initiative, the state awarded or distributed a total of $146.6 million to 133 agencies. The average size grant was $1.1 million. YoloCares’ award was the 11th largest in the State of California. Other area recipients include Full Circle Health Network, California Health Collaborative, Habitat for Humanity Yuba/Sutter, Mercy Coalition of West Sacramento, Pacific Clinics, and Stanford Sierra Youth & Families.