Bernstein Fellow Alumni Ron Gaskins Testifies to the Power of Team-Based Care
It takes a cooperative and effective workforce to accomplish value-based, quality-driven care. Ron Gaskins, executive director of Access East, is an alumni of the Jim Bernstein Fellows program. Gaskins is leveraging healthcare communities in the direction of team-based care.
Access East is a nonprofit located in Greenville, NC, whose mission is to improve the health status of the underserved and indigent in eastern North Carolina through enhancing access to quality health care and implementing and coordinating healthcare delivery models. Access East is part of Community Care of North Carolina, a care network that’s evolved over 25 years, with support from the NCFAHP.
“We provide wrap around services for high-risk Medicaid patients with an interdisciplinary team focus,” said Gaskins, “We deploy care managers to the home in a timely fashion in order to keep patients out of the hospital.”
The interdisciplinary team at Access East and their partners collaborate with primary care providers in an ambulatory setting to proactively engage and manage chronically ill patients before their conditions become severe enough to merit care in higher-cost, more acute settings such as the emergency room. Access East uses a vast network of professionals (e.g., registered nurses, social workers, pharmacy technicians, pharmacists, patient advocates, health coaches, etc.) to support its initiatives, which encompass transitional care, medication management, pediatrics, chronic pain, palliative care, and behavioral health integration. The goal is to navigate patients to the right level of care.
“Workforce development is key,” said Gaskins. “As value-based reimbursement becomes more and more prevalent, the right prescription of team-based care will be vital in effectively managing populations.” Access East has built a workforce infrastructure to ensure the transition to proactive and coordinated care. “This infrastructure requires a holistic framework around workforce diversity that taps into the many different backgrounds and experiences that professionals can bring to the job,” Gaskins added.
The constant need for more healthcare professionals looms in the background of every conversation on rural health. “More primary care physicians are needed, of course,” said Gaskins, “but to meet the demands in care that the coming decades will bring with baby boomers retiring and medicine extending lives longer will require using mid-level providers (i.e., nurse practitioners and physician assistants) to fill in the gaps. Moreover, connecting support staff such as nurses, social workers, and community health coaches with direct providers, we will begin creating team-based care models that can further assist in engaging patients and improving health outcomes.”
Gaskins gives the example of boosting the role of pharmacists in the coordination of value-based care. “The data tells us that Medicaid patients on average visit their primary-care provider two to four times a year, while they see their community pharmacy close to 20 times a year,” said Gaskins. “With this frequency of exposure to the patient, it makes perfect sense to engage the pharmacist out in the community more on chronic disease management.”
To accomplish this, Access East is partnering with Community Care of North Carolina on a project called Community Pharmacy Enhanced Services Network (CPESN) that financially rewards community pharmacists for conducting on-site education around medication management when people pick up their prescription, and reporting any important information back to the patients care manager and primary care provider. “We see the potential of expanding the medical home to more of a medical neighborhood mentality that encourages the cross-pollination of professional disciplines throughout the community,” Gaskins said. What’s needed to empower a workforce that drives value-based care? “Strong community connections, solid care coordination, and holistic, interdisciplinary teams,” he said. “We’re piloting projects to see what works.”
The Foundation is excited to announce Ron Gaskins, Bernstein Class of 2011—2013, as the first Distinguished Fellows Award Recipient. Ron will receive this award at the 10th Annual Jim Bernstein Health Leadership Dinner on October 8th, 2015.