Home Health CareSource: Addressing the social determinants of health

CareSource: Addressing the social determinants of health

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A female pharmacist sits with a male customer in the pharmacist consultation area and discusses his prescription and choice of medication viewing the details on a digital tablet. In the background a senior woman and granddaughter stand at the dispensing counter and are served by a female pharmacy assistant .

By Cory Sekine-Pettite

Healthcare is one of the most hotly debated topics in our national conversation. No matter where one falls on this issue politically, we all can agree on at least this fact: For those Americans currently receiving Medicaid benefits, it can be difficult to get all of the medical care they require without supplemental coverage. According to the Georgia Budget and Policy Institute, Medicaid provides nearly two million Georgians with vital health services, 92 percent of whom are children, elderly or disabled. It covers 1.3 million Georgia children and 500,000 seniors and other residents who live with disabilities.

CareSource Brand Logo-Vert-Tertiary-RGBThat’s two million of our friends, family members, and neighbors who need further assistance. One of the newer options for additional healthcare coverage in Georgia is CareSource, a leading nonprofit health plan whose metro office is located at Atlanta Galleria. In 2017, the Georgia Department of Community Health awarded CareSource the contract to serve Medicaid, PeachCare for Kids, and Planning for Healthy Babies (P4HB) participants. The managed care company is one of just four organizations awarded the contract and the only non-profit selected from a highly competitive field.

Bobby Jones“Some of the challenges that exist in Georgia relate to infant mortality. Georgia is not ranked as high as it wants to be in terms of education and some other areas. We have programs that help address those deficiencies in the state,” said CareSource Georgia President Bobby Jones. “Our administrative offices are in Cobb County, but we are a statewide program.”

Jones comes to Georgia after serving as COO at CareSource’s corporate headquarters in Dayton, Ohio for eight years. CareSource (caresource.com) is Georgia’s first and only non-profit managed healthcare organization servicing the Medicaid population in Georgia. While the company may be new to Georgia, it is not new to the industry. CareSource has a 30-year history of success in improving health outcomes for its members. Its goal is to get its members into a self-sustaining, independent stage of their lives where state support programs are no longer needed. That is a big point of contrast for CareSource in Georgia.

Dr. Seema Csukas“Our whole mission is around improving our members’ lives — improving their health and well-being,” said Dr. Seema Csukas, medical director for CareSource Georgia. “We want to make sure they have access to a wide range of healthcare providers, but we also think about all the other things that impact their life that can impact their health. So, we have a Life Services program that actually works either with our adult members, or for our pediatric members, it works with their parents as well. And we offer services with a life coach who can really help them try to figure out what is best for them. What are their goals in life? What are the barriers that are keeping them from being the healthiest they can be?”

In Georgia, the CareSource Life Services program offers coaching, supportive resources, job readiness, and placement opportunities. The goal is to help members reach self-sufficiency and lessen the support of government programs. “We offer resources to them. We connect them to community partners,” Csukas said. “If they are interested in getting educational advances, we connect them to GED services. If they’re interested in getting a job or maybe a better job, we connect them to our employer partners in the community. We help them with résumé building. We will provide transportation for them to get to job interviews.”

Here’s how the JobConnect program works: CareSource has established relationships with hundreds of employers who constantly are in need of workers and who often are willing to train new staff for their future careers. Wages typically range from $10-$15 per hour for full-time employment with benefits. Among the industries served through this program are customer service, distribution, education, food production, healthcare, HVAC, manufacturing, retail, and warehousing.

Jason Anavitarte“As we have members go through our life coaching process, we can find opportunities to place them in employment with those companies,” said Jason Anavitarte, director of state development and advocacy for CareSource. “JobConnect is an opportunity for CareSource to work with Georgia businesses to help close employment gaps that we have in various industries.”

Even though the unemployment rate — both nationally and in Georgia — remains low, Anavitarte said that Medicaid recipients may encounter barriers to employment not faced by the typical job hunter. “While unemployment is low and the economy is booming, there still are hundreds of thousands of Georgians who are still looking for work. They may face barriers, such as transportation, or it could be a substance use disorder. We see this as an opportunity to bridge the divide to help them overcome barriers and achieve their dreams and aspirations.”

Such services are far beyond anything you’re likely to find from for-profit healthcare insurance providers, CareSource says. “Philosophically, we look to move as many dollars as we can into services for our members,” said Jones. “Since we don’t have shareholders to service, our margins are relatively small compared to our competitors.”

Among those additional services for children in Georgia, CareSource has worked with Atlanta Public Schools, Children’s Healthcare of Atlanta, and Atlanta Ronald McDonald House Charities on a first-of-its-kind telehealth pilot program at Fickett Elementary School in southwest Atlanta. For the program, CareSource purchased and installed specialized equipment that allows the students access to medical providers without having to leave the school. The telehealth hardware is capable of real-time videoconferencing, store-and-forward high-resolution imaging, and other diagnostic technology to support and promote long-distance clinical healthcare. For example, if a student is complaining of an ear ache, providers from Children’s Healthcare of Atlanta will be easily accessible for diagnostics and to recommend treatment based on a virtual exam.

“The collaboration between Atlanta Public Schools, CareSource, Children’s Healthcare of Atlanta, Atlanta Ronald McDonald House Charities, and Georgia Partnership of Telehealth will allow us to advance healthcare for all of our APS students,” said Nicole Spiller, director of Student and Intervention Supports for Atlanta Public Schools in a news release. “This project removes barriers to students’ access to healthcare while ill, while also alleviating the inconveniences for a parent who would otherwise have to leave work to bring the child to a doctor’s appointment. It’s our intention to use this pilot as a model of virtual patient care and potentially expand to other APS schools and clusters.”

Currently, CareSource is serving approximately 230,000 members across Georgia — and nearly two million within the five states where it operates. Beginning Jan. 1, 2020, CareSource will expand and begin serving individuals on Georgia’s healthcare exchange. “Our Marketplace plan will offer the necessary coverage along with added benefits and rewards,” said Anavitarte. “We’ll be offering that in Cobb County.”