Plan Aims to Fund Health Care Delivered Outside Doctor’s Office

by Mark Richardson

AUSTIN, Texas – A new initiative seeks to improve a patient’s health without a visit to a doctor or a hospital.

The Factor Health program at the University of Texas at Austin’s Dell Medical School, funded by a $2.6 million grant from the Episcopal Health Foundation, aligns unconventional partners to identify, prove and pay for non-medical care outside of traditional settings.

For example, the program might use a healthy meal delivery system to change a diabetic’s diet to healthier food, lower his or her blood glucose levels, and have a health insurance plan pay for it.

Elena Marks, president and CEO of the Episcopal Health Foundation, says her organization aims to improve outcomes while cutting costs outside of a clinical setting.

“So, our role is funding what is essentially an experiment backed up with a lot of data collection and evaluation with the hope that if it proves true it becomes incorporated into the health care financing system,” she explains.

The program brings together an unusual group of players, including managed care payors such as Blue Cross and Blue Shield, social service providers such as Meals on Wheels, and grassroots youth development organizations such as Youth Rise Texas.

Marks says the first two programs to be tested through the Dell school would be managing diabetes for older adults and addressing the mental health impacts of family separation on high school age youths.

She says the goal is to prove the value of such programs to the people who pay the bills.

“People have done all sorts of things around diet and exercise to impact diabetes,” Marks points out. “What’s different about this is that we are trying to get it embedded in the health care delivery system so that it gets financed as part of health care.”

Marks says the goal is to demonstrate that if non-medical interventions can bring results, then they are worth something to a health insurance company.

“The main thing behind it really goes to the core of what Episcopal Health Foundation is trying to do and that is to change the conversation and the financing so that we actually are prioritizing health and not just health care,” she states.

Marks says the foundation will study the data and outcomes of the first two programs over a one-year period and consider funding new programs after that.