- Health and Well-Being
- Organizational Excellence
Health is more than just a set of clinical metrics. And we know that health is impacted by more than what happens at the doctor’s office. There is a direct connection between social determinants of health—factors such as employment, housing, and transportation—and poor health. In fact, social and economic factors are estimated to attribute to 40 percent of an individual’s health resulting in a widespread need to connect the health care and human services systems.
To meet the needs of the individuals that intersect with both systems, we know it is imperative that community-based organizations, health care providers, and managed care organizations align and partner. We also know that is easier said than done because the current system by which health care and human services are delivered is fragmented and misaligned. During this session, presenters will discuss overcoming these challenges and share how one managed care organization is working to incorporate services and supports to improve health and well-being by engaging in cross-sector partnerships with human services organizations.
This engaging and interactive session will include a high-level overview of the health care trend, specifically in the Medicaid system, to integrate health care and human services to provide whole-person care that addresses the social determinants of health. Participants will then walk through an example of how cross-sector partnerships with human services organizations involve different stages of engagement—screening, stratifying, referring, and follow up—to effectively meet the needs of the individuals we all are serving. The session will then transition to small-group projects, where participants will talk through a current cross-sector partnership example involving a community-based organization and Medicaid/health care plans or a hypothetical example of such a partnership to surface the opportunities and barriers/challenges. The full group will reconvene at end the session to discuss practice and potential policy changes that are needed to facilitate greater engagement between the health care and human services systems.
- About Medicaid and the role of managed care organizations in the health care system
- Examples of how health care payors, providers, and community-based organizations are partnering to address the social determinants of health
- Barriers that limit collaboration between community-based organizations and health care payors to address the social determinants of health
- Ideas to address these barriers
- Kevin Moore, vice president of policy for Health and Human Services, UnitedHealthcare Community & State
- Jane Pirsig, executive director, Aurora Family Service at Aurora Healthcare
Vice President of Policy for Health and Human Services
UnitedHealthcare Community & State
Kevin Moore is the vice president of policy for Health and Human Services at UnitedHealthcare Community & State. UnitedHealthcare Community & State serves nearly 6.4 million Medicaid members in 30 states, plus Washington D.C. UnitedHealthcare is a division of UnitedHealth Group (NYSE: UNH), which is a diversified health and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone. As vice president of policy, Moore focuses on the development of sustainable interventions that improve the health of those we serve by addressing social, economic, workforce, transportation and nutritional barriers. Prior to this role, Moore served as senior vice president of Medicaid Strategy for Aurora Health Care. Before joining Aurora Health Care, Moore was appointed by Gov. Scott Walker as Wisconsin’s Medicaid Director and Administrator of the Division of Health Care Access and Accountability in the Department of Health Services. Moore has served on a several boards and committees including the State Council on Alcohol and Drug Abuse (SCAODA) and the Wisconsin Child Abuse and Neglect Board. Moore holds bachelor’s degrees in history and political science from the University of Wisconsin-Madison.
Aurora Family Service at Aurora Healthcare
Jane Pirsig has over 30 years of leadership experience in mental health, social service, and aging services. Since 2002, Pirsig has led the integration of Milwaukee's oldest family service agency into Aurora Healthcare, a $5 billion regional health care provider with innovative services in clinic social work, social service navigation, chronic illness supportive counseling, public benefits counseling, emergency department interventions with high utilizers, targeted home visitation services for families of high-risk infants, and training in medical family therapy.
Pirsig has informed national innovation in addressing social determinants of health through work with electronic health recorder provider EPIC, the Wisconsin Association of Child and Family Agencies, and the Alliance for Strong Families and Communities. She holds a master's in business administration from the Kellogg School of Management at Northwestern University and a master's in social work from the University of Wisconsin.