Implementing Community Collaboration for SDOH with Michael Sattler, Founder of Advocate Advisors was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best audio automated transcription service in 2020. Our automated transcription algorithms works with many of the popular audio file formats.
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Welcome back to the Outcomes Rocket, Saul Marquez is here and today I have the privilege of hosting Michael Sattler. Michael is a 20 year entrepreneurial and strategic professional focused on social determinants of health. He has deployed social determinants of health collaboration networks around the country and believes that every neighborhood, town, public health department, and clinical practice should have one. The results are astounding. Improved health outcomes and better economics. A true revolution. His advisory practice advocate advisors was set up to help people create them. And today we’re going to cover how exactly they’re doing that and what exactly are the benefits. So, such a privilege to have you here on the podcast with us today. Michael,
Thanks. So it’s a pleasure to be here.
Absolutely. So before we get into the nuts and bolts of advocates, advisers, I’d love to hear a little bit more about you and what’s gotten you inspired to work in health care.
Yeah, sure. Well, as you mentioned, I’ve been in the startup community for most of my career, creating new products and new market opportunities. And I kind of have my ear to the ground all the time for new things to think about. And sometimes an idea comes along. It’s so compelling that I can’t do anything other than think about it all day long. And this is what happened with social determinants of health. I was lucky enough to join a company that is focused on it, and as I learned more about it, I realized that we are really looking at a greenfield opportunity here as a concept, as a market and industry, but really, most importantly, as a social movement. Social determinants of health is something that’s vitally important, I think just not just as a business or as a health care endeavor, but for our society. And so it’s really been a pleasure to be able to dive into it with all my heart.
So talk to us a little bit about it. Right. I mean, and the benefits are huge to be able to to account for the social determinants of health. There’s been an increased alignment, even in some payment models around accepting some of these things matter like transportation, food. So talk to us about what you guys are doing to help with social determinants of health.
Yeah, sure. I think this is it’s a topic that especially over the past few years has been around for a long time. I mean, the idea of social determinants of health is really in many ways synonymous with public health. But something’s changed over the past few years. A combination of technology and the business model changes that you’re talking about that have really opened the space up in some very compelling ways. People talk about social determinants of health as viable things that affect health outcomes. But a lot of people stop at the point of thinking of it as advocacy or as policy oriented things. If we could just solve the social determinants of health, then people would get healthier. But I think what’s really interesting to me is that there’s still a lot of questions in people’s minds about what to do with that once you’ve done that. How do you actually intervene in an individual’s situation in order to address some of the social determinants of health focused on a specific person? And that’s new. People have been thinking about it at a policy level, but the idea of addressable social determinants around a specific individual is new. And what’s really interesting is that over the past few years, I’ve been spending a lot of time designing and building initiatives that do those interventions in specific individuals’ lives. And we started the Advocate Advisors Company in order to really help people get a head start on the best practices that are coming on out there today. So what we do is we design these sort of practical, tech-enabled platform solutions that bridge the gap between health care and the community and the community-based organizations that are actually on the ground helping people with addressing specific social determinants of health. When you integrate that back with the HRR, you can really make a significant impact on people’s outcomes from a health perspective.
Now, that’s fascinating. I’d love to hear examples of some of these practical uses.
Sure. Well, one of the easiest ways to sort of think about it is we built a program out in California. California has been leading the charge and some interesting ways around social determinants of health. And they have a whole person care mandate that’s been passed down from the state and they’ve been trusted counties with implementing these sorts of whole person care approaches where you treat the individual and all of their social circumstances, not just any acute conditions they have. And one of the programs I was involved with up north of the Bay Area was involved in reaching out to people who are experiencing homelessness. And they pulled together a network of community organizations from shelters to emergency services to long term education, hospitals and providers, the Medicaid universe that was there in the county. Put that entire community network together, found a set of individuals who are experiencing homelessness, got them into the program, and literally within the first year and a half of using this very on the ground pragmatic approach, reduce the homelessness occurrences within this population by thirty three percent. They’ve got people into homes simply by managing that process in a collaborative way. That I think is really, really compelling. I’m seeing instances of this happening all over the country with specific social problems and more generic ways. There are lots of different models out there, but it really is fascinating to see that the technology can help enable outcomes that we’ve never been able to accomplish before in any other real way.
Yeah, that’s great. And so, as you think about what makes you guys different than what’s available today, what would you say is special about advocate advisors?
Well, I think Advocate Advisors is focused on the idea of these pragmatic, sort of tech-enabled programs around addressable social determinants in individual people’s lives. There is plenty of space out there for advocacy and for policy changes, for changing business models and systemic problems with our health care system and in our society as a whole. But what we do is we say, you know what, let’s do all that. But at the same time, let’s concentrate on building really targeted solutions for specific individuals. Let’s get systems where if a physician is dealing with a patient who happens to identify a social need, let’s get a social referral in there. Let’s get a prescription out there and have that individual enrolled in a platform or a network that can get them a group of people who can help them address their problem, not from a health care perspective explicitly, but from a community perspective. The people really helping focus on this in the grassroots or in the community so those partnerships can be enabled using the technology and using the new best practices that are out there. And that’s what Advocate Advisors does. Let’s help build that, help people build those networks around the whole country of it.
It’s great in enabling these groups to come together to help each other, be mindful about how care is being delivered is key. Tell us a little bit about maybe an example of how you guys have improved outcomes or improved the business model and a community.
Well, I think this is what you alluded to earlier is also coming true in a big way. Our health care system has several different business models, but one of the most compelling new ones is making a tremendous amount of progress. And that’s the sort of accountable care concept where an individual organization or a company is given the responsibility for managing all aspects of an individual’s health outcomes and is given a block of money in order to do that. And they get to keep there’s some incentive, they get to keep whatever they don’t spend and keeping that patient healthy. Suddenly the business model is around keeping people out of the hospital. It’s about lowering the costs of caring for them and taking a longer term view about keeping them healthy and solving those acute problems. So the world is transitioning to this model and experiments are extremely interesting. And I think that’s what these kinds of intervention programs could really make. A real difference here is that as ACOs accountable care organizations and MCOs, men of care organizations move more and more into the mainstream, the need to keep people out of emergency rooms and keep them healthy involves solving some of those social problems that affect their health. And these kinds of platforms, these programs that we’re helping build really can make a significant difference, not only in saving people’s making their lives better, but making it cheaper to keep them healthy. So absolutely feels like the future of health care here. And I think it’s really great to be part of something really pragmatic that can be done today that can influence those outcomes over the long run.
Yeah, it’s great how this has become a central part of the discussion. Very real. I remember five, six years ago, it was still kind of like Right. like a trend, but not really much going on. The first thing that I ever heard was like six, seven years ago, I was like, it’s cheaper to get a senior an air conditioner in an urban area. And it made me think Right. like you pay two hundred fifty bucks for an air conditioner or do you pay two hundred thousand dollars for open heart surgery? And that’s like, whoa, that was the first time that it that it clicked. And then little by little, it just started working its way into the day to day to now. I mean when you have some alignment and payment models, you’re moving the needle. So today you and your company are helping people operationalize this. And, hey, how do we make this real in our community?
So you’ve got it. Yeah, we had we had an example very similar to that up here in Boston where we had a single mother with a young child who had asthma. And we would rolled her in a program and we had a community health worker get out there and take a look. And it turns out that her apartment, their apartment where they lived had. Dust issues, so the the community health workers said, well, let’s let’s get you an air filter and it was a fifty dollar air filter. And that kid’s asthma literally went from chronic attacks every week, which brought him into the emergency room to virtually nothing within a week or two. And it was 50 bucks. And I think that’s part of the key here is that this is there are systemic issues that are big picture, but there are easy ways to solve a lot of these social issues that are both less expensive and better for people from a health care perspective. So I think you’ve nailed it. That’s where we can really make a difference these days, and we can do that today. This isn’t like pie in the sky trend. This is people are out there making it happen.
Yeah. Wow. That’s another great example. And so as you’ve embarked on this mission, Michael, what would you say is one of the biggest setbacks you’ve experienced and a key learning?
Yeah, good question. I think that we’ve talked about this. This is a transitionary period, I think, for the business models of all the traditional health care industry for good reason. Want to be sure that the programs that they are referring patients into are scientifically proven, repeatable in the same way a drug trial would be or anything else. You certainly don’t want anyone prescribing something that is going to have a deleterious or negative effect. But social programs like the one we’re describing have just they don’t quite work that way. Know the social context for an individual, the environment where they live, the culture and the language they speak, their individual behaviors are hard to standardize. It’s hard to reduce down to variables. And so individual interventions kind of need to be customized and they need to be unique to the community. So it’s difficult to replicate them from one community to another. And it’s difficult to compare them apples to apples as the health care community would really want to do. So one of the key learnings here is that we need to have slightly different metrics for measuring the success of these kinds of social programs than we do for drug trials or other sorts of intervention programs. And they need to be evaluated in terms of subjective outcomes to the individual, not just simple statistics, morbidity or cost or other sorts of things. But people are getting there. People are beginning to realize that this is a slightly different case and it needs a slightly different set of measurements. So what’s happening?
That’s a very good call. And so as you think about what you’re most excited to, obviously you’re excited about this idea for my voice. So what about the area of social determinants of health is most exciting team, Michael?
Yeah, well, again, going back to my pedigree as a startup and innovation guy, the amount of innovation and experimentation going on in this space is really inspiring. I mean, there are people on the ground making things up as they go and getting fantastic outcomes all over the place. And what’s really interesting to me, again, is a technology startup guy is that this technology is now on our side. It’s no longer a barrier to putting these programs together. It’s an asset. And so it’s allowed people to try a whole bunch of interesting approaches. And people are learning things so fast. That’s one of the reasons why I set up advocate advisors, is to sort of help people understand how rapidly the innovations are establishing best practices so that people don’t reinvent the wheel or make the same mistakes that were made in other places around the country. These programs are just changing so fast and there’s so much interest, not just from the health care community, but from the public health community. With Kubicek, you hear constant stories about how contact tracing is being done for covid and people are out there saying, let’s get you checked up. And people are saying, you know, what I really need is a ride to the doctor’s office. Can you help me with some of the social issues here? And that is putting these issues forefront in people’s minds? Police reform is another big question. Maybe we can find ways to augment public safety officials with a more effective social program like this in order to get people the help that they need rather than just simply referring them out to an impersonal system. So I think we’re going to see a lot of new programs like this in the next few years, and it’s exciting to be a part of it.
Yeah, no, I agree. It’s definitely exciting. And getting ahead of the game and logging the learnings and figuring out the pathways is certainly a way to add value to those looking to make these changes. And so really love the work that you guys are doing here. Michael, before we conclude, I love, if you could just share a closing thought with the listeners and then the best place where they could get in touch with the advocate advisors as well as yourself.
Absolutely. Yeah. It’s been a real pleasure. Thank you very much for highlighting this. I think that what is really on my mind here as we go into this world, especially with everything changing so fast around us and so many assumptions being questioned just in our day to day lives, there has been a long term recognition that social determinants of health are critical and IT advocacy for things like systemic racism, adjusting that and reforming the business model of the American health care system. These are noble and. Critical functions, they need to take place and people are focusing on them, but the key thing to take away here is that we can also make a difference in people’s lives right now with these kinds of programs that I’m describing. So I want all of those big picture questions to be asked and answered and addressed. But we can’t let that perfect world be the enemy of the pretty damn good right now. So there’s nothing stopping us, literally nothing stopping us from setting up these kinds of addressable social determinants programs and counties, cities, towns, neighborhoods all over the country and beyond, and really collaborating between the health care system and the community-based organizations that are out there. And we can do that right now, today. And that’s what advocate advisors to set up to do. Let’s think about this in parallel to that big question and start really getting on the bandwagon to make this mainstream. And that’s I think one thing I’d love your listeners to think of is don’t stop, don’t wake and start small and get it off the ground. Let’s start this process going, because you can make a difference immediately. So our website is out there. You mentioned at the top of the show, Affricate Advisors, DOT info to give you a little bit of information about how we do things. And we also have a video channel out there on YouTube called The Field Guide, where we’re trying to pull together these best practices and put them in a really accessible way. So that’s available to you as well. So keep an eye out for that on Twitter and elsewhere. But, yeah, it’s been a real pleasure to meet you all and to talk about what we’re up to.
Yeah, Michael, this is great, folks. Again, it’s advocate advisors, dot info if you want to. The full transcript, the notes and links that we’ve discussed on today’s podcast, just go to Outcomes Rocket that health and type an advocate advisors in the search bar and you’ll see it all there, Michael. Love your practical approach and what you’re doing. And I certainly wish you success and welcome all of the listeners that want to engage with you to help get their programs off the ground to connect. So, my friend.
Thank you. So it’s been a real pleasure. Good luck.
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