A new study published in the New England Journal of Medicine Catalyst showed that Waymark’s community-based interventions lowered hospital and emergency department visits and improved care quality.
San Francisco-based Waymark works with health plans, primary care providers, health systems and federally qualified health centers. It supports Medicaid patients by connecting them with community health workers, therapists, pharmacists and care coordinators in their area. Waymark helps them access community resources like food and housing, mental health support, medical appointments and medical equipment. The company currently operates in Virginia and Washington.
The study evaluated outcomes for 64,278 patients in two Medicaid health plans in Virginia and Washington. Rising-risk patients (those likely to have higher healthcare needs) engaged with Waymark were matched with a cohort of rising-risk patients not engaged with Waymark. The health plans also assigned these patients to 2,298 in-network primary care providers.
After a 6-month follow-up period, the researchers found that Waymark’s model reduced all-cause ED and hospital visits by 22.9%. This includes a 20.4% decrease in avoidable ED visits and a 48.3% decrease in avoidable hospitalizations for rising-risk patients.
In addition, the study looked at nine quality metrics and found that seven improved by an average of 11.8 percentage points over a calendar year. These metrics were completion of annual well-child visits, antidepressant medication management, follow-up after hospitalization for mental illness, follow-up after ED visit for mental illness, diabetes hemoglobin A1c management, breast cancer screening and postpartum care.
Waymark also has patients identify their goals when they first engage with the company, like improving blood pressure or managing substance use. The study found that among patients engaged with Waymark, 63.3% of goals were completed.
“When we founded the company, we committed, no matter what the results, whether they were favorable or unfavorable, we wanted to be publishing our results from this calendar year in a peer review journal. … [We found that] patients are utilizing care more effectively and efficiently, the quality of their care has improved and they’re meeting their own goals,” said Dr. Rajaie Batniji, co-founder and CEO of Waymark, in an interview.
Batniji added that the findings come at a time when a lot of Medicaid plans are facing headwinds.
“They’re slashing their earnings guidance because of the fact that costs are coming in higher,” he said. “And it seems to be the greatest unanswered question in healthcare today: How do you actually manage Medicaid? I think every payer and every provider actually knows the answer. They’re never surprised when they hear from us what we’re doing and how it works. I think the challenge for all of them has been, can you actually implement these kinds of solutions at scale? Can they be reproduced?”
Scaling is exactly Waymark’s plan for 2025, according to Batniji. This past year has been about proving its model, and now it aims to replicate its model in other parts of the country.
Photo: zimmytws, Getty Images
