Kat / Safety Net

May 8, 2019; FierceHealthcare

Recognizing that good health depends more on an individual’s access to housing, good nutrition, education, and a safe neighborhood than on their medical care, Kaiser Permanente is rolling out Thrive Local, a digital care coordination platform that makes it easier for its medical providers to connect patients to community-based social services.

Kaiser Permanente, a comprehensive nonprofit health system that operates in eight states and serves 12.3 million patients, has been a leader in integrated care delivery. But among their patients in key regions with the greatest medical needs, the health system finds that 29 percent of members face food insecurity and 23 percent report concerns about housing stability.

To make sure its medical centers are addressing these needs, Kaiser Permanente is partnering with Unite Us, a New York-based technology company, to build the infrastructure that will power referrals and data collection to evaluate outcomes. Kaiser officials emphasized that “the program will enable providers and caregivers to seamlessly match an individual’s social needs with the appropriate services from within a robust network of nonprofit, public and private resources.”

“We built networks for primary care and for specialty care; now we’re saying we need a network for social health organizations,” Dr. Bechara Choucair, chief community health officer, told FierceHealthcare.

Dr. Imelda Dacones, chief executive officer for Northwest Permanente, expressed enthusiasm for the new platform: “This tool will accelerate our evolution as a sector to next-generation care delivery—a community-integrated model that connects physicians, our patients, and health care systems to community resources that address our patients’ socioeconomic needs.”

One of the challenges for health systems attempting to become more closely integrated with social support services is that once a patient leaves the medical system, there is often no way to track whether that patient’s needs were met. Thrive Local addresses that challenge in two ways. First, it will be fully integrated into Kaiser Permanente’s electronic medical records (EMR) system. Second, it tracks referrals and service outcomes, using a continuous feedback loop to improve service delivery.

What’s not entirely clear is who will pay for these social services; will it be the health system? municipalities? charitable organizations? For the model to work, some of the $3.5 trillion the US spends on health care each year needs to move to funding the underfunded social service agencies and nonprofits that support social needs.

Kaiser Permanente has invested its own funds in the model, holding an equity stake in Unite Us. Bernard Tyson, the CEO of Kaiser Permanente, says, “That relationship allows us to partner with them at another level. It brings us together in a tighter, more strategic way.” Tyson explained to FierceHealthcare that the initiative “builds on Kaiser Permanente’s philosophy of operating as a ‘holistic health system’ with a focus on physical, mental, and social care.”

The platform will launch this summer; the plan is to roll out slowly over three years to all communities where Kaiser Permanente has medical centers. Kaiser plans to make Thrive Local available to community health centers and community-based organizations in the communities in which it operates as well, extending its reach to 68 million people

“By integrating this network into our clinical care, our members with unmet social needs will be connected to community services more efficiently,” said Dr. Choucair. “In addition, Thrive Local will be open to community health centers and community-based organizations to improve social health access for the entire community.”

Thrive Local is the latest effort by Kaiser Permanente to address the social needs of its patients. In January 2019, the health system announced it would put $200 million toward addressing housing and homelessness.— Karen Kahn