Peter Weir is the Executive Medical Director of Population Health at the University of Utah Health (U of U Health).The weir Intensive outpatient The (IOC) is a clinic focused on addressing the social determinants of health by integrating physical and behavioral health.
Weir talks about Utah’s ongoing efforts to address future social determinants of health 2022 Utah Reform and Health Policy Conference April 7th in Salt Lake City. U of U Health was also recently released Short film It emphasizes the IOC’s key strategies and overall care.
In this Q & A, Weir explains how the IOC, how clinics deal with social determinants of health, and how to model clinics based on what other healthcare systems have learned.
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Status of reforms: What are you spending your spiritual energy on? What’s the most important thing happening in Utah Healthcare from where you’re sitting?
Peter Weir: “I have a lot of support for getting the healthcare system to provide health-oriented health care for the population. People stumble upon the term” health of the population. ” It’s really about some important principles. Broadly speaking, the first is the ability to stratify the population in terms of risk. The risk can be virtually anything, including age, medical condition, race, and usage patterns. Next, design an intervention focused on improving the health outcomes of interest to the population. Finally, measure those results, learn from them, and make adjustments to improve. “
SOR: So, please tell us a little about the IOC. What does it do and what is its purpose?
PW: “The clinic’s premise is to partner with a unique Medicaid plan managed by the University of Utah Health Plan. We find members at risk, including medical, mental health, and drug abuse issues. The concept was to create a clinic that could move the needle to caring for people with these risk factors, improving their results, and reducing their unnecessary costs. Our hypothesis was that we could reduce unnecessary costs rather than the internal costs of working. That worked.
I learned a lot along the way.For example, that was always my assumption [patients] It will be medically very complex and fragile. What we learned immediately was choosing patients who suffered serious trauma during childhood and adulthood. I see how adverse childhood (ACE) leads to adult symptoms such as early onset of chronic illness, behavioral health problems, substance abuse problems, high-risk behavior, and ultimately premature death. I started reading more literature about what. We have noticed that we have used a population that we did not completely anticipate.
So we started hiring people in the clinic with the expertise to care for these people, like social workers who were absorbed in the principles of traumatic informed care, substance abuse treatment and harm reduction. We invited primary care providers who are team-oriented and interested in addressing the behavioral health needs of patients. We have created a clinic that provides services that meet the needs of patients. “
SOR: How are clinics trying to address the social determinants of health?
PW: “For me, that’s a really important question. Setting up a clinic like us motivates us to work on social determinants of health. In a normal service fee environment, it’s appropriate for social determinants of health. There are no resources or staff to deal with. This is a mismatch between the payment model and the care model.
I flipped the equation. We’ve changed it so that success improves health, reduces costs, and doesn’t generate revenue. When reducing costs and improving health, transportation problems, food shortages, precarious housing, and all these important social needs that affect a patient’s physical and mental health, etc. You will be prompted to deal with it. .. “
SOR: What do you think is the importance of such clinics in achieving the health of the entire population and the better health outcomes of underserved Utah?
PW: “The purpose of the clinic was to demonstrate that this model could be successful. It has a health consciousness of the population and focuses on improving the outcome of the population of people. What I like about is focusing on the Medicaid population. The Medicaid population has socio-economic challenges that the commercial population does not necessarily have.
It was always intended to be a focused effort that could demonstrate long-term economic sustainability while meeting the needs of patients. “
SOR: What is the University of Utah’s plan to further incorporate these IOC-type facilities in order to be more involved in the Utah community? What did you learn from the IOC?
PW: “There is an opportunity to scale up the IOC. It’s just a matter of building strong partnerships with other payers. We know that the model works well with Medicaid. The Medicare population and / Or it would be interesting to see a model like the IOC with a commercial population. I also started investigating other populations that could affect the entire medical system. I have renal failure, depression. We are working on several projects that focus on specific medical conditions such as illness and are finding opportunities to provide home care rather than facility-based. The theme of all projects is to improve patient outcomes and experience. , Focusing on how to reduce costs. “
This interview has been edited for clarity and length.
