Carrie Butler: Reporting to Utah on complex care

2019-12-06T08:28:37-07:00December 6th, 2019|Issue Update|0 Comments

As a public health and policy nerd working to understand the health care landscape in Utah and across the country, I was thrilled to attend the annual Putting Care at the Center Conference by the Camden Coalition in Memphis this October with the help from a scholarship from the National Center for Complex Care and generous donations from Action Utah supporters. 

I have long been enamored with the Camden Coalition and the beautiful work that they do to improve health outcomes of their cities’ most vulnerable populations. My initial introduction to Camden came via this video, which spurred me to begin encouraging local partners to build and support programs like this in Utah.  

What is complex care? 

Complex care is an attempt to address the social, physical and behavioral needs of patients which, when left untreated, can result in costly and extreme overuse of the medical system. We know that a small percentage of patients account for half of all healthcare spending in the nation. Thinking differently about how we can identify needs of patients further upstream of health problems can and does result in less costly healthcare and much better outcomes. 

Putting Care at the Center Conference

Camden’s conference was an opportunity to learn from providers, data analysts, and public health professionals who are working hard to create a better health ecosystem–a system that creates opportunity for healing with lower costs for our highest need individuals. We talked about the intersection of social determinants of health and the opportunities we have as community partners to work collaboratively to address needs in a way that prevents costly medical intervention. 

Other important topics included: 

  • Addressing social needs of older patients 
  • Complex care in the criminal justice system
  • Addressing inequity in maternal mortality rates

Bringing complex care to Utah

The issues discussed at the conference are issues that impact Utahns and that advocates are trying to address through policy and programming in our state. Of particular importance here in Utah are the vast and complex issues around housing. I made a point at the conference to participate in discussions about the impact that adequate, safe and healthy housing has on preventing major costly and irreversible health problems. I look forward to bringing back important concepts and ideas from the conference to discussions being held here in Utah to create critical collaborations in the public health and housing sectors to achieve better health outcomes and reduced costs.

What’s happening with complex care in Utah now

We have many chances as a society to make life better, easier, and more meaningful for our families and neighbors, and we are fortunate to have many good people doing that work in our state. Here is some of the work around complex care already underway in Utah:

  • Intermountain Healthcare is working on a pilot program that addresses the social determinants of health in a few different communities. 
  • University of Utah’s hotspotting program, in collaboration with the Camden Coalition, works to identify high utilizers of emergency services and works to address their social determinants to improve outcomes and reduce use.
  • Countless community-based health organizations are doing incredible work to lift the burden of poor health from people who need it the most. 

Yet there remain many people who fall through the cracks. It is imperative that we as a state begin to look for ways to better coordinate in our efforts to identify and intervene. Two ways our state could improve include:

  • Utilizing community health workers to play a vital role in coordinating care and identifying needed interventions 
  • Using measures other than reduced emergency room visits to determine efficacy of programs and intervention in order to be able to tell the full story about a patient

We do a lot of things well in Utah, and I am confident we can utilize complex care concepts to create collaborations that achieve better outcomes in our state. Creating better, lower cost, high-quality care is a top public health priority at Action Utah, and I look forward to bringing new information to our work in the community and among partners and stakeholders. 

To those of you who donated to fund my trip to the Camden conference, a big thank you for your support and interest in this important work! I look forward to seeing you all on Capitol Hill during the upcoming legislative session to help Utah advance good public health policy! 

    — Carrie Butler, Policy Director at Action Utah

PS – On a personal note

Aside from complex care, some of the most moving experiences for me at the Camden conference had very little to do with health care at all. The conference was held in Memphis, home of the National Civil Rights Museum, which was built around the motel where Dr. Martin Luther King Jr. was assassinated. I had the opportunity to spend an afternoon learning in greater depth about the civil rights movement along with many of the conference attendees. 

One of the attendees, participating on a panel, articulated her feelings about the experience in a way I hope to carry with me. She talked about the efforts of those who risked life and limb to create a more equitable and just world for all, regardless of race or circumstance. She talked about how proud she was to look out at the attendees and recognize that people who are so engaged are only perpetuating that work and that the thought of so many, engaged in such important and beautiful work helped her feel connected in a way that nothing else had. 

The final speaker as the conference wrapped up, summed up those feelings with this oft spoken quote: 

“The greatness of a community is most accurately measured in the compassionate action of its members.” – Coretta Scott King 

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