Haywood is leveraging technology to address community-level health needs.
Nutrition and transportation deserts are affecting communities nationwide. But the Blue Cross Blue Shield (BCBS) Institute is implementing affordable and easily accessible programs to help address these issues. Through these initiatives, the organization helps individuals live healthier lives outside the clinical setting and in their own homes and neighborhoods.
Trent Haywood, M.D., J.D., is senior vice president and chief medical officer (CMO) of the Blue Cross Blue Shield Association (BCBSA.) He also serves as the president of the BCBS Institute.
Haywood and BCBS are using initiatives like FoodQ and RideQ, which provide meals and transportation, to address social determinants of health in local communities. Haywood is also leveraging technology to address the needs of several patient populations.
I spoke with him to learn more about the opportunities that the institute presents and the challenges it’s facing. We also discussed how he is using technology to address social determinants of health within a full workload.
A graduate of the University of Notre Dame, Haywood received a medical degree from the University of Illinois in Chicago. He finished his internal medicine residency at Loyola University and holds a law degree from Northwestern University School of Law.
Editor’s note: This interview has been lightly edited for length, clarity and style.
Trent Haywood: If you’re talking about improving the health of a population, that means 60 to 80% relates to the social determinants of health. We have an opportunity to make a difference from a population health standpoint. What’s nice about it is that individuals can feel it, and it resonates with them at the local, individual level as they live out their lives.
For example, look at nutrition. The nutritional service we offer is called FoodQ.We see there are three fundamental barriers that impact an individual’s opportunity to have a healthy lifestyle through their nutrition. One is that it’s not as convenient as fast food. Another is that it’s not as affordable as fast food. The third is that nutritional food is not as flavorful as fast food. So we set up an opportunity through Blue Cross Blue Shield Illinois and Health Care Service Corporation to deliver food through the Chicago market. Now we are moving to the Dallas market. And we’ve overcome those three barriers.
First, we made it convenient. It’s a home-delivery model of ready-to-eat meals. When they’re delivered, after two minutes in the microwave or 20 minutes in the oven, you’re ready to eat it. It’s no different than when you think about the convenience of fast food.
Second, we made it affordable. Instead of it being low volume, high premium, it is high value, low price. We did that in a way that says, “If you buy one meal, you get the second meal free as part of our subscription model.”
Finally, we made it flavorful. We know there is a misconception where people think that the only way you can eat healthy is to eat food that doesn’t taste good. We spent a lot of time in the local community doing meal tasting to make sure everything is really flavorful. And we get positive reviews on the taste.
It’s exciting because you can imagine other individuals at the community level saying, “Wow, BCBS really cares about if we’re living a healthy lifestyle, and they’re not waiting until I’m in the hospital setting. They’re helping me in my day-to-day life.”
Trent Haywood: We worked with HCSC, which is the parent company for five other plans in the BCBS system. Through our Community Health Management (CHM) Hub, we wanted to see the nutrition deserts in Chicago and then Dallas. Nutrition deserts don’t just lack access to adequate grocery stores, but that lack of access was also associated with avoidable hospitalizations and emergency room visits.
We did the CHM Hub analysis to clarify which zip codes in Chicago market are nutrition deserts. Once we agreed with HCSC, we set up the FoodQ to start a program where we can deliver meals in a convenient, affordable and flavorful way.
Then we knew we wanted to take advantage of local expertise. We worked with a local operator called Kitchfix in Chicago and Front Porch Pantry in Dallas to say, “You’re in this community. You’ve already been delivering meals. Can you create a meal catalogue specific for FoodQ?” Then we can deliver the meals in the communities with nutrition deserts.
Trent Haywood: Healthcare organizations incorporating social determinants of health is still relatively new. So awareness is a big challenge. We want people to work with us to raise awareness about how critically important this issue is and that we care about what’s happening at the hospital level and in the community setting. We need to get the word out, especially because FoodQ is not just offered to BCBS members. Even though BCBS is providing a service, we’re doing it for the broader community. We don’t want people to worry about their insurance. We want people to be aware of the service in their local market and to take advantage of it.
But once individuals subscribe to our service, we actually have high retention of over 90%. That shows that the work we are doing in the community to make sure the food is flavorful is paying off.
As we are moving forward, others ask about how we are going to scale the program. We are in Chicago and will go to Dallas, but we want to scale it nationally as much as possible, and we are taking on that challenge to make sure it is available in as many communities we can.
Trent Haywood: One way is through our proprietary platform CHM Hub, which is granular and gets down to an individual block group level. It simulates proprietary data and public data to identify where the opportunities are to engage a community because it’s not a one-size-fits-all model for the social determinants of health. You need to know which social determinants require which solutions as you get into the neighborhood or community level.
Second, we have RideQ, our transportation service. On that application, we wanted to work with plans and members to overcome barriers to transportation to medical appointments. With the application, members don’t need to download different ridesharing apps. All you have to do is text “Ready,” and a car comes to pick you up or take you home from an appointment. Or we text you and say, “Are you ready?” and you can respond, “Yes,” and the car will come pick you up. The technology makes it seamless and simple to take advantage of the transportation services, as long as they are eligible for that particular service.
Trent Haywood: You’re going to see more investment and opportunity in people trying to make a difference through the social determinants of health.
We set up our application so that you aren’t limited to just one transportation company. You can use Uber, Lyft, Intelliride for a wheelchair-assist vehicle.
We also can do member eligibility right then and there and integrate our data with the plan and the customer service center. So there are some unique integration aspects that set us apart.
But at the end of the day, I think it’s just another signal of how important the social determinants are to benefit community members across the country, and you will see more investments in these particular areas.
Trent Haywood: From the beginning, we said that BCBS is unique because we are in every zip code. Because we are in every zip code and community, we are able to consider the difference of populations at the local level. And the CHM Hub helps us better understand what’s occurring and decide how we intervene when needed.
We make sure to identify the social determinants of health that might be an issue in a certain community and the impact we can have.
We have scenario planning as part of CHM Hub to identify which social determinant is important for the local planning and the impact of the solution put in to address the issue.
Trent Haywood: There’s that old adage, “You want something done, give it to a busy person.” I think that rings true in my situation. The reality is, for anyone working in this particular field, it feels like you come out of a community and you give back to the community you came from. If you can’t be inspired by this work, you’re probably not in the right field. I’ve always said healthcare, at the end of the day, is a business. But it’s really a profession. That profession is all about one group of people coming together to help another group of people. And that’s all we’re doing here. We’re not limiting ourselves to what’s happening in the hospital or clinical setting. If we really want to move the needle and help Americans live a healthier lifestyle, we have to be out in the community.
I’m honored and excited that the board allowed me to be the president of the Institute. I don’t take that lightly, and I consider it an honor to serve my community in this way.
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