Our Research
As a public benefit company, Waymark is committed to learning from our research, sharing our findings, and moving community-based care forward.
Supporting Rising-Risk Medicaid Patients Through Early Intervention
We assessed outcomes from our early interventions for 64,278 patients covered by two Medicaid health plans and assigned to 2,298 primary care providers (PCPs) spanning multiple practices in the states of Washington and Virginia. We found that Waymark achieved a 22.9% reduction in all-cause ED and hospital visits, including a 20.4% reduction in avoidable ED visits and 48.3% reduction in avoidable hospitalizations for rising-risk patients receiving Waymark services (compared to a matched control group of rising-risk patients over a 6-month follow-up period).
The Risk Of Perpetuating Health Disparities Through Cost-Effectiveness Analyses
We examined how competing risks, baseline health care costs, and indirect costs can differentially affect cost-effectiveness analyses for racial and ethnic minority populations. We illustrate that these structural factors can reduce estimated quality-adjusted life-years and cost savings for disadvantaged groups, making interventions focused on disadvantaged populations appear less cost-effective.
From Veneers To Value: Data Science Can Enable High-Value Care In Medicaid
We argue that persistent data quality issues and insufficient integration of clinical and social risk factor data have contributed to the growth of value veneers by limiting the ability of Medicaid programs to proactively identify and deliver targeted interventions to at-risk patients. We also outline how recent advances in data science can enable Medicaid programs to deliver higher-value care to beneficiaries.
Medicaid Expansion and Racial-Ethnic and Sex Disparities in Cardiovascular Diseases Over 6 Years: A Generalized Synthetic Control Approach
Findings report that Medicaid expansion was associated with a reduction in cardiovascular disease (CVD) mortality overall and in particular among minority and female subpopulations.
Financing Thresholds for Sustainability of Community Health Worker Programs for Patients Receiving Medicaid Across the United States
We sought to estimate minimum threshold Medicaid payment rates to enable CHW program sustainability, and found that higher Medicaid fee-for-service and capitated rates than currently used may be needed to support financial viability of CHW programs. We also present a revised payment estimation approach that may help state officials, health systems and plans discussing CHW program sustainability.
Prediction of non emergent acute care utilization and cost among patients receiving Medicaid
Patients receiving Medicaid often experience limited access to primary care, leading to high utilization of emergency departments for non-emergent conditions. We tested alternative widely-debated strategies to improve Medicaid risk models, the results of which demonstrate a modeling approach to substantially improve risk prediction performance and patient equity.
A Social ACO For Medicaid Managed Care
Numerous studies have shown that the failure to address individuals’ health-related social needs (HRSNs) can result in poorer health outcomes and increased health care costs. Here, we propose an alternative value-based arrangement for Medicaid managed care that addresses social needs by placing primarily non-clinical staff at the center of care to maximize impact..
Advancing Access to Care in Washington State
Access to quality primary care is associated with improved health outcomes and lower medical costs, but social drivers of health (SDOH) can impact access to care. Patients with the greatest risk for poor health outcomes may be disconnected from primary care. Connecting these patients to primary care improves health outcomes reduces emergency department utilization and reduces total cost of care.
Value Veneers And How To Enable Value In Medicaid Care Delivery
Here, we argue that adoption of value-based care (VBC) in Medicaid has been limited due to a lack of revenue optimization opportunities via risk adjustment, the complexity of implementing VBC models across state Medicaid programs, high member churn, and the growth of “value veneers,” or modest value-based arrangements that nominally pass as VBC but do not meaningfully alter care delivery.
Estimated Costs of Intervening in Health-Related Social Needs Detected in Primary Care
In this decision analytical model, the cost of providing evidence-based interventions for social needs averaged $60 per member per month. The findings of this study suggest that a substantial increase in resources would be needed to implement a comprehensive approach to addressing social needs that falls largely outside of existing federal financing mechanisms.
