Around 70 percent of Medicaid is managed by private health insurers, which theoretically are incentivized to lower costs and treat patients’ conditions before they spiral into more expensive and serious ones. However, the dominance of the fee-for-service model can hinder this, and there is insufficient infrastructure and resources to make other cost-effective interventions, the report said.
San Francisco-based startup Waymark suggests that by implementing community health workers and workflow management software for primary care clinics, it could alleviate many issues that plague Medicaid patients.
“They’re really looking to use the infrastructure in place today to stitch together a better member experience and a better set of clinical outcomes,” Mohamad Makhzoumi, managing general partner at investment firm NEA, said of Waymark in Forbes.
The founders of Waymark, Sanjay Basu, MD, and Rajaie Batniji, plan to contract with Medicaid managed care organizations and provide them with a new workforce of salaried community health workers as well as specialized software. They told Forbes that those interventions will help streamline patient journeys and connect them to cost-reducing wraparound services.
