When he was growing up in Canada, Yusuf Rashid saw a trend among the Canadian celebrities he admired. Neil Young, Michael J. Fox, Wayne Gretzky—they all moved to the United States to realize their potential contribution. Rashid didn’t want to pursue a career in Hollywood or sports, but he did see opportunities south of the border in his chosen field of healthcare.
What he saw was a hybrid healthcare system bursting with potential. “You have private systems and for-profit systems that coexist with national or regional government and not-for-profit models,” Rashid says. “There’s no better environment that you’re going to find out there for innovation and to bring about potential for revolutionary change.”
However, he also saw that these systems incentivized insurance companies, care teams, and patients to pursue different outcomes, leading to fragmented and uncoordinated care. He envisioned a different system in which the pillars of healthcare focused on a single goal. “I believe the best healthcare system is when you have a delivery system where the care teams and the health plan are aligned with the patient’s goal of staying well,” he says.
This vision brought him to Community Health Plan of Washington (CHPW), a not-for-profit managed care plan that was founded by Washington State’s community health centers, where he now serves as vice president of pharmacy and vendor relationship management. Rashid’s role encompasses both prescription drug and medical benefits, giving him a holistic view of the health plan and positioning him to create solutions to more effectively integrate with the community health centers.
He began by addressing challenges within his own department. When he joined CHPW in 2014, the pharmacy department was not achieving target cost or quality outcomes. Instead of focusing on cutting costs alone, they refocused their attention on value—delivering the highest quality care at the lowest price. “By focusing on a model that’s built around value, we were able to improve measurable outcomes for adherence as well as dramatically reducing the amount of high-risk medications that were prescribed,” he explains.
To increase the quality of care, they redefined CHPW’s relationships with the community health centers, developing clinical partnerships, sharing data and resources, and launching pilot programs to empower physicians and pharmacists. “What really forged our partnership was designing around the needs of the patient in a collaborative manner,” he says. “Not judging based on bad outcomes, not preaching or patronizing our provider partners, but problem-solving together with the goal of taking the best care of the patient as possible.”
“Guiding the healthcare system to do the right thing for the patient is a core component of our corporate vision at MCG Health,” says Jon Shreve, president and CEO of MCG Health. “MCG is proud to be a component of the informed care strategy that Yusuf has implemented at CHPW. Yusuf’s success shows that putting the patient at the center of care can not only improve patient outcomes but also create efficiencies in the healthcare system as a whole.”
CHPW’s members, and their needs, are diverse, so they tailored their approach to serve each community’s needs. No single approach would work across the entire system. “Depending on which community we’re looking at in the state, we need to be aware of how we can reach the patient with care that resonates with them, and that recognizes their point of view, as well as their risks and their vulnerabilities,” Rashid says.
One way CHPW is addressing this challenge is by sharing accurate and timely data with community health centers to better target patient engagement efforts, both for individual patients and population health. The twenty community health center partners use six different EHR systems, so CHPW partnered with Arcadia Healthcare Solutions, a health technology company, to aggregate clinical-provider data and health-plan claims data between the providers and health plan. “For our community health centers and primary care providers, having visibility to the clinical data that’s in their EHR together with our pharmacy claims data within the Arcadia system helps us get a more complete picture of the individual patient and allows us to see trends in different regions, different clinics, and different communities,” Rashid says.
In certain Hispanic populations, for example, the data shows that a disproportionate number of patients don’t take antidepressant medication as prescribed. Patients that care providers engage with immediately after they begin taking medication have better adherence rates in the long run, so Rashid and his team developed a pilot program to better support newly diagnosed patients in these populations with more timely interventions.
“Patients taking antidepressant medications are at highest risk of stopping their medications early on in treatment,” he explains. “We’ve developed accurate, but also timely reporting to identify patients that are newly diagnosed and engage them with support in the first couple of weeks of their first prescription fill. This gives them the support to hopefully improve their chance of taking the medication properly in that critical first three months.”
Another pilot program empowers pharmacy partners to meet with diabetic patients to reinforce the physician’s initial diagnosis and aid in medication management. CHPW recognizes their community health center pharmacy partners as care providers, and reimburses them as such, further integrating the responsibilities of the traditionally separate healthcare providers. “That has resulted in improved engagement from the patient, empowering the patient to understand the importance of their medication treatment, and to improve their follow-up by taking medications as prescribed and getting their diabetes better under control,” Rashid says.
This system-wide integration mirrors the way that CHPW approaches individual patients. On the institutional level, integration means viewing all parts of the healthcare system as interrelated parts of a cohesive care model. On the patient level, CHPW views behavioral, mental, and physical health as interrelated parts of a holistic person. Effectively addressing the patients’ needs requires re-envisioning the care delivery system. “The need is so great, but unless you have an integrated, holistic approach to patient care, it’s going to be very difficult to actually improve outcomes for members,” he says.
When he came to the US at the beginning of his career, Rashid saw an opportunity to revolutionize a system through an integrated model and, in particular, through using managed Medicaid to serve the most vulnerable patients in the healthcare system. “When I look at the problems with healthcare in the US, I can’t think of a challenge that’s closer to the problem we’re trying to solve than managed Medicaid,” he says. “If we can solve the challenges in managed Medicaid, I think the rest of it is going to be easy.”
Photo by Erik Stuhaug