By Frazer Buntin, Chief Operating Officer, Wayspring
I was traveling with one of our Community Outreach Specialists a few weeks ago who does street outreach for the most complex members we serve and I had an interaction that really stuck with me. We were trying to find Rodd, a member who was engaged with our support services and was 3 months into his recovery. Rodd did not yet have a “normal” place to live and was living inside the auto-garage in which he worked. His job was a great start for his life, and he was building his way to a stable place to live.
When we met Rodd to do a check-in, he explained that he only had one kidney and had been going to the hospital every three months for kidney stones. Not only were these instances painful but they were disruptive to his job and expensive for the healthcare system. As we stood on the sidewalk with Rodd, he casually mentioned that the hospital told him during his last admission that the kidney stones may be coming from the tap water which could have chemicals from old pipes.
Upon hearing this, I said “You should get a Brita water filter!” As soon as the words came out of my mouth, I realized it was a classic statement to come from the corporate guy. Rodd responded, “Bro, I don’t have any money, time, or way to get to the store.”
Fortunately, our Community Outreach Specialist picked up the task and was able to connect him with resources to get the water filter in short order. Now, I haven’t studied the latest ICD and CPT code books, but I am fairly certain there is not a CPT code for “assist patient with obtaining a water filter pitcher.” Under the fee for service reimbursement model, we never would have been able to help Rodd in this innovative way. Because Wayspring takes risk on the total cost of care, we can make small “bets” on what we think will work to improve care and lower costs for our members. I love this part of our business model. This flexibility is one of the most rewarding parts of our company.
And good news, the last time we connected with Rodd, he said that he had not been back to the hospital with kidney stones! I don’t know if the water filter pitcher is the sole reason, but I do know that financial risk = appropriate pressure = innovation = outcomes.