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Health disparities among our most vulnerable populations are a great concern in our market. We still see lower-income, linguistically isolated people have less access to healthcare and community resources. This is poignant in New Jersey, where the cost of living is so high, yet about one-third of people in our area live on an income below the ‘survival budget’ threshold. This results in disparate health outcomes and alarming mortality rates for disorders like diabetes.
We need to do a better job of making sure these populations have proper coverage and access to care. We need to help physicians, clinical staff and healthcare facilities develop population health management skill sets. We need to expand use of patient risk assessment tools and analytics, better understand where our resources should be focused and ensure our efforts result in quality delivery with measurable outcomes.
Lack of engaging and activating our patients take the effectiveness out of our efforts in healthcare. Patient non-compliance with medical care plans, along with lack of healthy lifestyle choices, have a detrimental impact to the health of our populations. We are providing direct, culturally-tailored services and investing in approaches to improving physical activity and nutrition, partnering with local organizations that serve vulnerable populations, and working to decrease wait times for specialty care for Medicaid and charity care patients. We also launched a system-wide health literacy initiative to make healthcare communication less complex.
In addition, we are working through our ACOs — Atlantic Health System ACO and Optimus Healthcare Partners ACO — to educate providers on implementing team-based population management models.
We also need to better wield the power of healthcare information. Information that is accessible, integrated and transparent can bring us the clinical intelligence to ensure gaps in population care are managed while also documenting the value of all interventions. We have invested in the ability to aggregate data from multiple sources, perform advanced analytics and then develop actionable reporting.
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