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November 18: Today on the Community channel, it’s an Interview in Action live from CHIME’s Fall Forum with Ray Lowe, CIO & SVP at AltaMed Health Services. How do federally qualified health clinics prioritize their health IT initiatives? How does a leader transform a system from a two and a half star rating to four and a half stars? What does their governance model look like? How do they tie data analytics into their foundation? What are their five strategic pillars? Will value-based care finally come together in 2023?

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

interview in action from the:

All right. Here we are. Another interview in action from the Chime, Fall Forum, and I'm here with Ray Lowe with AltaMed. Ray, great to see you again,

lly when they walk into Chime:

We are standing right here at the doors. You walked in and just grabbed you. Looking forward to the conversation. Thank you. For those who aren't familiar, tell us a little bit about Ultimate.

Sure. So I'm the Senior Vice President, Chief Information Officer, Ultimate Health Services. I've actually been there five years. This. Five years. Yeah. Yeah. It's been quite a ride. And Ultimate is, it's really like a large provider group. We have a family companies have belonged to us, so we, we are the largest FQHC in the country, serving over 400,000 lives.

We have PACE programs and we also have a Medicaid insurance product as well as a managed services organization. So from when I joined five years ago, Ultimate primarily was an fqhc. And revenue was actually almost doubled in terms of that whole time period of this growth.

So Primarily the LA market,

Los Angeles, Orange County primarily Latino, multi-ethnic, underserved communities.

Wow. Yeah. You guys really have grown, I mean, five years since you've been there. Yeah. We don't usually talk about growth with a federally qualified health clinic. So I mean, what's driving that is. That just the needs of the community are driving that?

Well, Well, you know, the studies are showing, right? There's more growth in Medicaid, in the Medicaid population, and the pandemic really accentuated what had to happen when everybody lost their jobs. The, the safety net, the community health centers is where people really gravitated to and more people lost having private insurance and then went into the Medicaid space in there.

dicaid insurance. And then in:

How has the delivery of care changed since the beginning of the.

en I joined Ultimate January,:

So it was a lower performing health organization. I'm a really proud, now we're four and four and a half stars. So not only have we to extend the access, we are also able to improve the. You know, and that's demonstrated by CMS and by the health plans and how they're rating us. So again, for that very vulnerable patient population, we can prove, right, You can have better outcomes, you can manage chronic diseases, diabetes, hypertension, et cetera, and you can make a change on it with the proper healthcare.

What's the technology foundation for that?

We're epic. We've been epic for four years, and you know, from our whole tech stack, I, I made a big bet on Cisco. As well as enc. We have NetApp, all those other traditional folks, our CM crm as a Microsoft, we're about to do man new erp, which is gonna be Workday as well.

But what we're really looking at next year is more in the value-based care model and really growing more inside of Epic. So Epic has claim loader, which comes in, we don't have a hospital, so we we, you know, work with community hospitals and so now bring in the claims data for those we call we restric.

You know what that is? It's the type of Medicaid insurance product. So we're able to focus then on those and then actually then do more Medicaid risk stratification. So we're really excited. We're gonna start this program in February, and our first cohort of five health plans will go live in July, and then we're gonna do 10 more after that.

So I think it's really gonna be really great Medicare, medicaid, improving it, bringing the full picture of the patient together from a data perspective.

So talk to me about analytics and data. Because when you talk about improving quality scores and those kind of things, and I think I wanna start with data and then I want talk about access models and that kinda stuff. Talk to me about the foundation of data.

Sure. Well, you know, data's hard, right? We, we actually have a new chief data officer, Greg Townsend, who joined us about a month ago. It came to us from Massachusetts Blue Cross Blue Shield Arena. So we're gonna be partnering together, So, so on the epic side, We're keeping the clinical data repository inside of Epic at the point of care.

Now, the interesting thing on the data warehouse is how are we actually building the interoperability, the association from the multiple health plans in there? You know, we, there's kind of more reactive view of data and we get to the more predictive view of data, but we have some work to do in order to grow that maturity and that we've been a bit more siloed in terms of replacing a number of large.

And now it's really focusing on that data and the data transformation to get to get to more of the predicted aspect of it in terms of what's happening.

Talk to me About access the community that you serve is interesting. And when you talk about the quality scores going up, it would lead me to believe that there's more interactions, like they are able to interact with the physicians more and they're coaching on, on health and those kind of things.

So talk about access a Yeah, so, you know, at the pandemic February 29th, let's call the date, right. The pandemic started on February 29th, 2 29. Great amount of memory. And you know, we pivoted by April, everybody was closed. And I think, you know, during the pandemic we primarily did about almost all tele at the peak of it, at the end of about 70%, but we're still maintaining about 30% of tele.

We offer them as an alternative in addition to the in person. And we're, we are looking to improve some of our primary service lines on maternal and pediatrics as well, more the senior areas. So we're looking at being a more specialists into those type of video type of visits to help those patients.

Interesting. you know, as I think of coming through the pandemic Federal Qualified Health Clinic, you Generally don't have money to throw around at things. How did you prioritize what you were gonna do?

Yeah, so at our core of it, our ceo, costly Rocha, we've always been very focused on, on culturally competent care and really improving care for the underserved communities around there.

So you know, we have an excellent chief quality officer be who and dear who helps us really stratify the, measures Where and what we're going to do. So we look at what are the measures, those 30 or so measures that we're looking to improve. And then we're also looking, you know, how are the health plans, you know, utilizing it.

And we define our, our programs around there. You know, epic's been great. We have a clinical informatics teams, which is also part of my organization. I think I obviously have about 10 positions, ironically, part-time on my step, which is fabulous. Right? Right. Because you can change so much that happens in the organization when they're predictive, the workflow, the training, all those different areas that impacts, you know, the end users in rather, but it's, it's looking at what are, what are the quality goals that we need to meet?

What are we doing to intervene? How are we doing? it And then with an executive physician leadership, we have leaders that help us really understand what do we need to do. You know, we're changing some things on tele we've done some other stuff in RPM as well, and like tuning it around value-based care or transitions of care from hospitalization. It's a pretty interesting stack moving.

📍 📍 All right. We'll get back to our show in just a minute. We have a webinar coming up on December 7th, and I'm looking forward to that webinar. It is on how to modernize the data platform within healthcare, the modern data platform within healthcare. And I'm really looking forward to the conversation. We just recorded five pre episodes for that. And so they're gonna air on Tuesday and Thursdays leading up to the episode. And we have great conversation about the different aspects, different use cases around the modern data platform and how agility becomes so key and data quality and all those things. So great conversation. Looking forward to that. Wednesday, December 7th at one o'clock. Love to have you join us. We're gonna have health system leaders from Memorial Care and others. CDW is going to have some of their experts on this show as well. So check that out. You can go to our website thisweekhealth.com, top right hand corner. You'll see the upcoming webinars. Love to have you be a part of it. If you have a question coming into it, one of the things we do is we collect the questions in the signup form because we want to make sure that we incorporate that into the discussion. So hope to see you there. Now, back to the show.

📍 📍 What does your governance model look like? For, taking on new initiatives?

Yeah. That's great. So our ceo, right, So that's our. So we have five strategic pillars, one value-based care data growth people and social determinants of health. So we look at how do things align within there.

Last year we did a lot of focus on people, our most important assets, and that's part of our e r P program. An ultimate, actually in June announced a livable wage ahead of the state of California, the state of California. Putting legislation out there at $25 an hour is supposed to be in the minimum wage for a hospital worker.

We actually moved to that in June, you know, which is a bit disruptive to your revenue and other areas other, but how you're gonna make it up. Again, the governance model goes tied to those five pillars. Sorry. I spent a lot of time what we did last year on there, and then we really tied the initiatives around there.

What are the outcomes in there this year? Again, it's a lot of. Going into value-based care, you know, on the data we're, we're pretty good on the people aspects of it. We're also like building a nursing school as well in a pipeline with Loma Linda University. Wow. I mean, there's just so many things happening at Ultimate.

what are you most excited about for next year?

I really wanna see the, the value-based care really kind of come together. I'm so passionate about, you know, improving the quality, the outcome, the interventions, you know, We've looked at the health equity divide. We, we've shown that we can improve things and, and there's so much momentum in there, you know, and we can continue to change people's lives and improve their lives.

Non English speaking, poorly educated living in multi-family housing, you know, and that, that they can make a difference. I think I shared with you before that there was this amazing PBS special that was released in the summer. It goes, we are where we. And it talks about in East Los Angeles through Orange County, what happened in there.

There used to be a number of battery plants in there, lead poisoning, all that proper right in there, the proper care around there. And that's happening today. And it's even back to the pandemic when people talked about the social, because that land is, It's all polluted. It's polluted, yeah. Yeah. It's polluted.

They dig down two inches and they remove it. Yeah. Wow. Yeah. So there's so much we need to do in terms of our. Yeah, absolutely as well,

Ray, thank you. Appreciate your service. I mean, that's, that's phenomenal work that's going on out there. Ultimately.

Appreciate it. Thank you. Thank you.

Another great interview. I wanna thank everybody who spent time with us at the conferences. I love hearing from people on the front lines and it is Phenomen. That they have taken the time to share their wisdom and experience with the community, which is greatly appreciated. We also want to thank our channel sponsors one more time, who invest in our mission to develop the next generation of health leaders. They are Olive, Rubrik, 📍 trx, Mitigate, and F5. Thanks for listening. That's all for now.

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