Geisinger Health Plan

GEISINGER HEALTH PLAN STRIVES TO MAKE BETTER HEALTH EASIER BY PROVIDING ACCESS TO AFFORDABLE, HIGH QUALITY HEALTH CARE TO THE COMMUNITY THROUGH EQUITABLE, INNOVATIVE, AND INCLUSIVE CARE AND COVERAGE MODELS.

TRANSITIONS OF CARE HELPING PATIENTS TRANSITION THROUGH LEVELS OF CARE, FROM HOSPITAL TO HOME, IS AN IMPORTANT COMPONENT OF ENSURING COMPREHENSIVE AND HIGH QUALITY HEALTHCARE SERVICES. GEISINGER HAS IMPLEMENTED NEW STRATEGIES WITHIN THE HOSPITAL AND PRIMARY AND SPECIALTY SETTINGS TO ANTICIPATE PATIENT NEEDS AND COORDINATE SERVICES TO ASSURE TIMELY AND SAFE TRANSITIONS. THESE STRATEGIES INCORPORATED TIMELY COMMUNICATION FROM THE HOSPITAL TO PRIMARY CARE PROVIDERS, LEVERAGED DATA FROM ELECTRONIC HEALTH RECORDS & CLAIMS TO IDENTIFY RISK AND USED CASE MANAGERS TO PROVIDE EARLY FOLLOW UP SERVICES. GEISINGER'S EFFORTS AROUND TRANSITIONS HAVE DEMONSTRATED MORE COORDINATED FOLLOW THROUGH AFTER DISCHARGE AND REDUCTIONS IN READMISSIONS. ELECTRONIC HEALTH RECORD (EHR) GEISINGER IS ON THE FOREFRONT IN THE DEVELOPMENT AND USE OF THE EHR. GHP HELPED SUPPORT THE 100 MILLION INVESTED IN EHR OVER THE LAST SEVERAL YEARS. ENDLESS POSSIBILITIES EXIST FOR IMPROVING THE QUALITY OF CARE WITH THE EHR. GHP USES THE EHR TO COMMUNICATE WITH MEMBERS WHO ARE INVOLVED IN MEDICAL OR DISEASE MANAGEMENT PROGRAMS AND THEIR PHYSICIANS. GEISINGER ALLOWS COMMUNITY HOSPITALS AND PHYSICIANS TO ACCESS PATIENT INFORMATION TO CARE FOR THEIR PATIENTS. DISEASE AND CASE MANAGEMENT SERVICES TO IMPROVE THE HEALTH OF MEMBERS, GHP PROVIDES DISEASE AND CASE MANAGEMENT PROGRAMS AND SERVICES TO COORDINATE CARE FOR THOSE WITH CHRONIC CONDITIONS. THE PROGRAMS ARE FOCUSED ON CONGESTIVE HEART FAILURE, HYPERTENSION, DIABETES, CORONARY ARTERY DISEASE, OSTEOPOROSIS, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, CHRONIC KIDNEY DISEASE, ASTHMA, TOBACCO CESSATION AND WEIGHT MANAGEMENT. THESE PROGRAMS WERE THE RESULT OF A COLLABORATION OF EXPERTISE BETWEEN GHP AND GEISINGER PROVIDERS AND HAVE ATTAINED NATIONAL RECOGNITION BY HEALTH MANAGEMENT ORGANIZATIONS & INDUSTRY GROUPS. THIS SUCCESSFUL COLLABORATION IS AN EXAMPLE OF HOW THIS UNIQUE RELATIONSHIP BENEFITS THE COMMUNITY. COMMUNITY HEALTH, EDUCATION AND OUTREACH GHP EMPLOYEES PROVIDE THE PUBLIC WITH INFORMATION ON TOPICS SUCH AS INSURANCE EDUCATION, ADVANCE DIRECTIVES, DENTAL AND HAND HYGIENE, ASTHMA CARE, THE IMPORTANCE OF SCREENINGS & IMMUNIZATIONS AND WELLNESS. GHP PROVIDED INFORMATION TO 43,441 INDIVIDUALS AT 1,818 EVENTS INCLUDING HEALTH FAIRS, SCHOOL BASED PRESENTATIONS, SEMINARS AND ORGANIZATIONAL MEETINGS. THIS EDUCATION INCLUDED: -339 HEALTH EDUCATION EVENTS FOR CHILDREN WERE HELD COVERING DENTAL, NUTRITION & PHYSICAL ACTIVITY, HAND HYGIENE AND SUN SAFETY TOPICS, REACHING 3,062 CHILDREN AT THESE EVENTS. -NEARLY 370 EVENTS SUPPORTED EVIDENCE BASED CHRONIC DISEASE PROGRAMMING, REACHING A TOTAL PARTICIPATION OF OVER 350 INDIVIDUALS. -OVER 1,415 WELLNESS ACTIVITIES WERE HELD AT EMPLOYER GROUPS AND COMMUNITY EVENTS. ALL OF OUR PROGRAMS ARE AVAILABLE TO OUR COMMERCIAL MEMBERS WHICH REPRESENT APPROXIMATELY 171,643 INDIVIDUALS. -A COMMUNITY FLU EVENT WAS HELD, PROVIDING 161 FLU SHOTS. GHP EDUCATES THE GENERAL PUBLIC, MEMBERS, EMPLOYER GROUPS, BROKERS, PARTICIPATING PROVIDERS AND OFFICE PERSONNEL ON HEALTH AND WELLNESS TOPICS RANGING FROM WOMEN'S HEALTH TO COLD AND FLU PREVENTION. THE INFORMATION IS AVAILABLE IN A VARIETY OF FORMATS INCLUDING NEWSPAPER ARTICLES, NEWSLETTERS, EMAILS, BROCHURES AND POSTERS. GHP SUPPORTS MANY LOCAL ORGANIZATIONS THROUGH COMMUNITY SPONSORSHIPS. THE ORGANIZATIONS INCLUDED LOCAL CHAMBERS OF COMMERCE AND THE BOY SCOUTS OF AMERICA. THE COST OF COMMUNITY HEALTH, EDUCATION AND OUTREACH ACTIVITIES WAS 4.4M DURING 2023. HEALTH EQUITY AT GEISINGER HEALTH PLAN, FOSTERING DIVERSITY, EQUITY, AND INCLUSION (DEI) IS FUNDAMENTAL TO OUR MISSION TO PROVIDE OPTIMAL CARE AND ENGAGE WITH OUR COMMUNITIES. IN 2021, GEISINGER HIRED ITS FIRST CHIEF DIVERSITY, EQUITY AND INCLUSION OFFICER (CDEIO). IN THIS ROLE, THE CDEIO IMPLEMENTED A MULTIPRONGED STRATEGY THAT PRIORITIZED THE IMPORTANCE OF IMPLEMENTING STRATEGIES THAT SUPPORT HIRING DIVERSE TALENT, CREATING AN INCLUSIVE CULTURE, SUPPORTING COMMUNITY ENGAGEMENT, PROMOTING HEALTH EQUITY, AND ENSURING SUPPLIER DIVERSITY. THE HEALTH EQUITY STEERING COMMITTEE (HESC) SUPPORTS THE HEALTH PLAN AND CLINICAL ENTERPRISE TO PROVIDE GOVERNANCE OVERSIGHT OF THE HEALTH EQUITY STRATEGY. THE HESC HAS CREATED FOUR SUBCOMMITTEES TO ASSIST WITH DATA, PATIENT AND MEMBER SERVICES, COMMUNITY HEALTH INITIATIVES, AND CULTURAL COMPETENCY. IN 2023, GHP IMPLEMENTED HEALTH EQUITY STEERING COMMITTEE, WHICH GUIDES THE HEALTH PLAN IN ADDRESSING DISPARITIES AMONG SPECIFIC POPULATIONS. THE STEERING COMMITTEE GUIDES THE STRATEGY, WORKFLOWS, AND PROCESSES UNIQUE TO GEISINGER HEALTH PLAN AND IS COMPRISED OF A MULTIDISCIPLINARY TEAM OF KEY LEADERS AND STAKEHOLDERS FROM ACROSS THE HEALTH PLAN. THE GHP STEERING COMMITTEE HAS 5 PILLARS OF FOCUS: INFORMATION GATHERING, DATA AND REPORTING; HEALTH PLAN OPERATIONS; MEMBER ENGAGEMENT, PROGRAMS, PILOTS AND INTERVENTIONS; VENDORS, PARTNERSHIPS AND CBOS. IN OUR ELECTRONIC HEALTH RECORD, WE HAVE DEFINED DATA ELEMENTS, CLINICAL WORKFLOWS AND ORGANIZATIONAL PRACTICE TO ASK PATIENTS AND MEMBERS THEIR RACE, ETHNICITY, LANGUAGE PREFERENCE, SEX, GENDER IDENTITY, SEX ASSIGNED AT BIRTH, ORGAN INVENTORY, AND AFFIRMATION HISTORY, INCLUDING UTILIZING THE SOGI SMARTFORM TO COLLECT ADDITIONAL INFORMATION OF PRONOUNS AND SEXUAL ORIENTATION, AS WELL AS VETERAN STATUS. THE SAME DATA ELEMENTS WERE ADOPTED BY THE HEALTH PLAN FOR WORKFLOWS AND DATA COLLECTION. GHP ALIGNS INFORMATION TECHNOLOGIES FOR MEMBER DATA MANAGEMENT. WE INVEST IN DATA INFORMATICS TO DEVELOP PATHWAYS TO COLLECT HEALTH CARE DATA, WHICH WE ANALYZE USING REPORTING TOOLS. WE IDENTIFY OUTCOME DISPARITIES DUE TO INEQUITIES AND SOCIAL DETERMINANTS THAT IMPACT OUR MEMBERS' HEALTH AND BUILD INTERVENTIONS AND PROGRAMS TO CLOSE THE GAPS. THIS ENABLES US TO INCORPORATE THE WAYS WE COLLECT KEY DEMOGRAPHIC DATA, SUCH AS RACE/ETHNICITY, LANGUAGE PREFERENCES, AGE, SEXUAL ORIENTATION, AND GENDER IDENTITY. GEISINGER CONTINUES TO DEVELOP NEW AND INNOVATIVE WAYS TO UTILIZE OUR DATA TO BEST SERVE OUR MEMBERS. BRANCHING OUT FROM OUR USUAL DATA SETS HAS ALLOWED US TO USE OUR DATA TO GUIDE AND IDENTIFY WHERE HEALTH DISPARITIES MAY EXIST ACROSS RACE, ETHNICITY, AND OTHER FACTORS. IT HAS ALSO ALLOWED US TO IDENTIFY PATTERNS IN HEALTH DISPARITIES WITHIN OUR MEMBERSHIP, HELPING US UNDERSTAND WHERE AND HOW TO BEST TARGET OUR EFFORTS. WE HAVE LEVERAGED THIS DATA TO IDENTIFY TARGET DISPARITIES AND COMMUNITIES AND WORK TO FORM PARTNERSHIPS WITHIN THE COMMUNITY TO ADDRESS THE IDENTIFIED DISPARITIES. GEISINGER UNDERSTANDS THAT OUR MEMBERS ARE THE TRUE EXPERTS WHEN IT COMES TO THEIR HEALTH AND THE VALUE THAT THEY ADD THROUGH THEIR VAST KNOWLEDGE OF THEIR OWN COMMUNITY AND THROUGH LIVED EXPERIENCES OF THEIR OWN. THIS MULTIFACETED APPROACH CONTINUES TO GUIDE US AND HELP US UNDERSTAND THE IMPACT OF DIFFERENT DISPARITIES IN THE DIFFERENT COMMUNITIES AND WORK COLLABORATIVELY WITH OUR MEMBERS AND OTHER VALUABLE COMMUNITY STAKEHOLDERS TO FORM PARTNERSHIPS, CRAFT TARGETED INTERVENTIONS TO REDUCE DISPARITIES AND IMPROVE HEALTH OUTCOMES FOR OUR MEMBERS. SOCIAL DETERMINANTS OF HEALTH GEISINGER IS PROACTIVELY ADDRESSING SOCIAL DETERMINANTS OF HEALTH (SDOH) AND HEALTH DISPARITIES IN A VARIETY OF WAYS. WE HAVE MOVED BEYOND TRADITIONAL MEDICAL CARE TO PROVIDE COORDINATED SOCIAL SERVICES AND OPPORTUNITIES TO OUR PATIENTS AND HEALTH PLAN MEMBERS WHILE CONNECTING THEM WITH COMMUNITY-BASED ORGANIZATIONS. WE ARE WORKING ACROSS SECTORS TO FIND CREATIVE, INNOVATIVE WAYS TO HELP INDIVIDUALS ADDRESS THE SOCIAL AND ENVIRONMENTAL FACTORS THAT IMPACT THEIR HEALTH. COMMUNITY HEALTH BENEFIT FUND WHILE STABLE HOUSING, FRESH FRUITS, VEGETABLES, AND TRANSPORTATION OPTIONS ARE OFTEN NOT DEEMED HEALTH CARE NEEDS, THEY, ALONG WITH OTHER NECESSITIES, ARE VITAL TO POSITIVE HEALTH OUTCOMES. THE COMMUNITY HEALTH BENEFIT FUND WAS ESTABLISHED TO PROVIDE COMMUNITY ORGANIZATIONS WITH RESOURCES AND SERVICES NEEDED TO FOSTER POSITIVE HEALTH OUTCOMES. THE KEY AREAS WITH FUNDING NEEDS IDENTIFIED INCLUDE: 1.FOOD 2.HOUSING 3.TRANSPORTATION 4.MEDICATION 5.CONNECTIONS 6.SAFETY 7.CHILDCARE 8.CLOTHING 9.UTILITIES 10.EMPLOYMENT FUND RECIPIENTS MUST BE A 501C3 AND ARE APPROVED BY THE COMMUNITY HEALTH BENEFIT FUND COMMITTEE WHO MEET QUARTERLY TO DISCUSS NEEDS AND GAIN APPROVAL OF ALLOCATED FUNDING WITHIN THE GEISINGER FOOTPRINT. IDENTIFICATION OF NEEDS: WE HAVE BEEN SCREENING OUR MEMBERS AND PATIENTS FOR SOCIAL NEEDS SINCE 2018 AND IN 2021 IMPLEMENTED A SOCIAL NEEDS SCREENING TO IDENTIFY URGENT NEEDS WITH MEMBERS AND PATIENTS. THE SCREENING IS DESIGNED TO SURFACE THE MOST URGENT NEEDS OF OUR PATIENTS AND MEMBERS. AT THE CONCLUSION OF THE SOCIAL NEEDS SCREENINGS, PATIENTS AND MEMBERS ARE THEN ASKED TO SELECT THE DOMAIN(S) THEY WOULD LIKE TO RECEIVE HELP. RESPONSE TO IDENTIFIED SOCIAL NEEDS: AS GEISINGER STARTED TO SCREEN FOR SOCIAL NEEDS IN 2018, THE ORGANIZATION ALSO BEGAN THE JOURNEY TO IDENTIFY A VENDOR TO UNIVERSALLY ADDRESS SOCIAL NEEDS, PROVIDE OUR CLINICAL AND CARE MANAGEMENT TEAMS WITH RESOURCES, PROVIDE OUR PATIENTS A