Hi, everyone. Good afternoon, and thank you for joining us for today's webinar, scaling social care through local partnerships, a practical model for advancing health equity and member outcomes. My name is Joel Nellis, and I serve as senior manager for accreditation policy at NCQA. I'm one of the content experts in health equity and health outcomes for the policy team. I'm pleased to be your host for today's discussion. As health care organizations continue to address social drivers of health that impact the communities they serve, many are asking an important question. How can we scale social care initiatives while maintaining meaningful, effective partnerships at the local level? Today's webinar will explore how health plans and community based organizations can work together to address member members' social needs through a practical model that combines national strategy with local expertise. We will hear from real world world examples of how organizations are strengthening partnerships, levering social care data and improving outcomes for Medicaid populations while advancing health equity. If questions arise during the session today, please use the Q and A function to ask those questions and we'll address those at the end of the session. NCQA will also share a recording with participants after this webinar. Today we're fortunate to be joined by five leaders with deep experience in social care, community engagement, and Medicaid innovation. Fanon Game serves as referral coordinator at the Foundation for Sickle Cell Disease Research. Fanon is committed to creating efficient systems and streamlining referral processes that support the high quality, compassionate care the foundation is known for. She truly values the opportunity to collaborate with a dedicated team focused on improving access to care and enhancing the patient experience. Malika Harrison is senior director of community relations at Sunshine Health and has nearly twenty years of experience in community outreach, philanthropy, communications, and public private partnership development across Fortune five hundred corporations and nonprofits. In her current role, Malika oversees eleven statewide community connection centers from Miami to Pensacola and leads strategic partnerships and programs, grant portfolios, and field marketing that delivers measurable social impact while deepening stakeholder engagement. Melanie Vu is program manager of the system systems of health team at Health Net. She leads strategy and implementation for Cal and community supports programs, including closed loop referrals and initiatives that address behavioral health and social determinants of health. Doctor Benjamin Martin is senior director of programs and strategy at Project Angel Food in Los Angeles. Ben's portfolio includes, its medically tailored meal accreditation, the implementation of its grants and programs, and its client facing technology. He's responsible for community relationships and health care partnerships, including the organization's collaboration with Health Net under CalA. He oversees client services, nutrition services, and dish dispatch departments. Previously then worked at as an employment lawyer on the senior management team of University of Southern California Alumni Association. He joined Project Angel Food in twenty nineteen. Brandon is going to be our moderator today for the discussion, and Brandon brings over ten years of experience in community and social determinants of health strategy. Currently, he serves as as account director at Find Help, where he manages executive partnerships and the success of enterprise health system and health plan accounts. Together, our speakers will share lessons learned from implementing social care programs at scale. Thank you all for being here today. We appreciate you sharing your expertise with our audience. And with that, I'll turn it over to Brandon. Thank you, Joel, and thank you, NCQA, for hosting today's panel discussion. Appreciate the introduction. I'm gonna start us off with a quick summary of Find Help and our role in the social determinants of health space. We are the nation's leading digital s u h closed loop referral platform, having received best in class award for five consecutive years. Our national database includes over nine hundred thousand free and reduced cost social care resources that staff and their community members can navigate to. We've proudly supported over a hundred and twenty million distinct users and serve more than eight hundred and twenty five customers, spanning health plans, health systems, government, and education. You can explore our company page at company dot findhelp dot com or search resources directly at findhelp dot org. I'll drop those URLs into the chat in a moment in case you're interested in exploring either. As part of my work at Find Help, I have the pleasure of working closely with today's panelists on their social care strategies, and I look forward to moderating our discussion. Thought we'd dive right on in and ground ourselves in the policy and the regulatory landscape space. California and Florida approach social determinants of health through slightly different Medicaid frameworks. Let's start from a health plan perspective where Mellon, California leverages more of a structural whole whole person mandate via CalAIM. Can you share how this Cal AIM community supports model has shaped yours and Centene Health Net SEO strategy? Yeah. Thank you, Brandon. So before I jump into just Cal AIM and community supports, I like to just provide a little bit of just background on California's CaliM initiative. And so back in twenty twenty two, the Department of Health Care Services launched a multiyear initiative, right, which was referred to as CaliM. And CalAIM stands for California Advancing and Innovating Medi Cal, which is, California's eleven fifteen waiver here. Right? And over the past five years, that we've implemented CalAIM, it has really transformed, social care into, a core component of our population health strategy, right, as well as all of the programs within Caling. It is really designed to, advance whole person care, right, really by addressing the health related social needs. And as we all know, you know, before Kalang, many social programs were small pilot projects or short short term grant funded projects. Right? And that was what we were doing at the managed care plan is really funding some of these programs. But Calendly really created a a statewide framework that allows health plans to integrate social care into the delivery system and the population health strategy. There are several programs and services that fall under the CALIM initiative, but one important aspect, as you mentioned, Brandon, is the community supports. And these are optional services for the health plan, although they are not quite a benefit. HealthNET did make a decision to opt into all fourteen community supports because we do recognize that, you know, factors like food, housing, housing services, home modifications, day habilitation, and many other social needs have a direct impact on health outcomes. And so within that first two years of implementation, we did successfully stand up, you know, all fourteen community support services at the time within, you know, thirty one counties here in California. Right? And that required really building a whole new provider network, developing operational workflows, establishing referral pathways, and creating reportings and oversight processes. The state also developed policies on CaliM as well, which also created accountability where they establish, you know, the service definition for each of the programs and services, eligibility criteria, putting expectations on, you know, utilization management and reporting requirements to make sure that social care are being integrated into the delivery system. So, ultimately, these policy really help make social care a regular part of health care instead of as an extra service. Right? So the goal is really to do more than just to refer members to resources and services, but it's about really creating strong partnerships between health plans, providers, community organizations, and members, so that members can get, the support that they need to really improve their health, as well as reduce disparities, and support that whole person care approach. Yeah. Yeah. Really well said, Mellon. And we'll talk a lot about partnerships today and appreciate the perspective and how that policy is impacting, you know, Centene California, your HealthNET plan, how you're operating. Malika, in a similar capacity, you know, where Florida's a little bit less of that whole person mandate that we're seeing in the CalAIM and the Health Net initiatives there, but whereas Florida still has the contractual SUH screening mandates, you know, how is this impacting your team and your work, today? Sure. No. Thank you for for the question. And and, really, now that the state is requiring and measuring the work that we've been doing with community based organizations for years, we do really do feel that that natural alignment. And so we, Sunshine Health, has long recognized, you know, barriers to transportation, food insecurity, housing instability, unemployment as factors that, you know, need to be addressed so that the entire continuum of care, from referrals to health is really, bringing to bear how we're assisting our members. And so, together with our partners, those are are that's who's really best positioned to address a lot of those factors that I mentioned previously. And we've been very intentional about investing in those partners, one of them being the Sickle Cell Disease, Foundation for Research, recognizing that we can't do this work alone. And those are truly, the experts and the ones that also have a deep reach into the community to to coordinate, care. And so with the the mandate and with the requirements, it really does speak to just putting a greater emphasis on the documentation, on the tracking, the reporting, the measurements. And and, truthfully, that collectively helps all of us to deliver those better beneficial health outcomes to to our members and to the community. And, you know, as we all know, what gets measured counts, and so we are are standing, you know, hand in hand with the state to make sure that we are being compliant in addressing those requirements. Yeah. And I'm hearing a similar theme, Melon, Malika, on partnerships. Super important. Operationally, you're you're running in stride with the policy. You're operationalizing at your organization and for your staff, but the CBOs, the partners are are super helpful and supportive in that process. And, we have Ben and Fanon on as a part of those partnerships that support y'all's work. And so next question, shifting over to them, from a CBO and from a programs lens, When these health care policy shifts start happening, what is your organization's immediate reaction? Did you initially see it as an opportunity for sustainable funding, or did you worry about all the requirements that accompany the health care and and health plan space? Happy to, share a few thoughts. So first of all, thank you, Joel and NCQA, for for hosting this today, and thank you, Brandon, and Find for moderating. Help has been a great resource for our team and and our clients. I think you asked the question, were we looking forward to it, did we see the potential, or were we a little worried? I think both. Yep. Yes. And so project angel food has been around since nineteen eighty nine. We've served about twenty one million meals over our lifetime and serve about one point five million per year right now. We helped originate along with our fellow members of the National Food as Medicine Coalition, the concept of medically tailored meals, through our work with people living with HIV and AIDS when we were founded and over the ensuing years. So, one of the I'd say that this was a long time coming in many ways and something that we were working toward and that we certainly saw and believed in the benefit of and continue to do so. Before CaliEM was adopted, and and Melon gave a really terrific background as to that framework in California in the beginning of twenty twenty two, California had already been looking at nutritional health care, especially in the, kind of top tier intervention of medically tailored meals. There was a Medi Cal pilot, again, Medicaid, but we call it Medi Cal in California. There was a pilot, to assist people with congestive heart failure that we state sponsored and that we were part of along with several other agencies. So that was already looking at feasibility and the impact of the service that we we delivered. So, certainly, when this became part of the broader framework of CaliM and one of the, dozen plus community supports that was adopted in twenty twenty two, we were thrilled. This really opened up a whole new avenue of business relationships, of impact, of funding, and so that was very exciting. At the same time, it is a different world. I think we've all I've been as you heard with project Angel Food since twenty nineteen, and we have been, learning to speak different languages and different acronyms and different systems. And and, we viewed ourselves as part of health care for a long time. This is truly walking the walk now and being more of an integrated part of health care. So we are also learning compliance duties and, and such other things that come along with that. But that's true, I think, both in the grants world, that a lot of community really, community based organizations are used to as well. So that's part of the work that we do as well. Thanks. Yeah. Ben, I think the acronyms alone will probably keep you up at night and keep you busy for a day or two. Banana, may may segue to our second question here and lean on you for response. As expectations around these outcomes, accountability and quality measures continue to evolve, how has that changed the way your organization thinks about partnerships with health plans? Yeah. Thank you, NCQA, for holding the space for this conversation and Brandon for moderating. And so just to speak on the experiences that we have to both speak on quantitatively for measuring the data, for compliance that we were speaking of, we recognize that the numbers only tell part of the story. So we like to track the traditional measures, of course, but we also understanding that, you know, completing a referral, for example, is only the beginning. The true impact may not be immediately visible in data. So we like to look at improved stability and the better management of health conditions, patients feeling more supported and, in turn, being supported enough to remain engaged in their care. So we pair our metrics with patient feedback and lived experiences and barriers we identify throughout the referral process, and we feel like that's very valuable information. It's not whether the referral was simply completed, but what obstacles the patient faced and whether the services, rendered were actually the, address their needs. So we like to combine the insights that give us, a more complete picture of how successful the process is and how we can improve our systems and partnerships. Yeah. Yeah. That's really great. And and I'm hearing a a consistent theme on the evolution of the policy for both the health plans and and the partners, how you're evolving, and how your organizations are changing to fit that bill and to to run-in parallel with that work. I think that's a a good transition from the regulatory landscapes in in discussion to highlighting really the two different approaches, that we're hearing here between California and Florida, and moving out of that initial planning and response phase to actually service delivery. Melon and Ben, let's start with you and the work happening in California, where HealthNET started with the focus of five to ten organizations to assess operational readiness. Can you both talk a little bit about the process and how it moved from that readiness assessment to service delivery? And then also elaborate, you know, looking back, what capabilities were most critical in determining whether CBO was ready, for that deeper partnership? Yeah. So standing up is just, standing up the services for us in California was only, you know, one part of that work. Right? We really quickly learned when we started implementing, Caliene, was that it really dependent on, as you mentioned, Brandon, is, the strength and readiness of our providers and our community based organization, within the you know, within CaliM. Right? So when we first launched CaliM in twenty twenty two, we worked with several health plans across the state and local organizations to really develop a universal community supports application. Right? And also a review process to really assess readiness of our providers before contracting and onboarding. And so through that process, we, know, really evaluated factors like operational capacity, staffing, services, delivery capabilities, right, reporting processes, data management, which really helped us to identify organizations that were ready for a deeper partnership or a deeper conversation. But also at the same time, it it really helped us to determine where technical assistance, and support might be needed for organizations or smaller organization who may need additional support, before bringing them on for, that deeper partnership. Right? And so within the first year, we onboarded a little over fifty providers, with, you know, within community supports, across all four fourteen services and throughout our counties. And so one of our early priorities, of course, you know, in partnership with you, Brandon, you know, as you mentioned, you know, as social you you know, these social care network and close referral was really to build that referral ecosystem, right, and to really connect the health plans, providers, and community based organizations to better support members. And so what we really quickly learned was that, you know, not every organization was ready to manage yet another system or technology platform as part of their delivery system. And so we understand that, you know, building a referral ecosystem really requires more than just the technology. It really required creating meaningful connection between organizations and strengthening relationships, among all of our providers. And so in partnership that we had with find help, you know, we hosted meet and greets kind of across the state, really bringing together our contracted calling providers and community based organizations into one room to really create an opportunity for our organizations to really meet one another, share best practices, discuss operational challenges, and how they could really build more of a stronger relationship. But, also, at the same time, what we really wanted was really them to exchange contact info right, really to really start to build that intentional partnership on and organic referral. And so, you know, it's really important for us that the collaboration and the capacity building locally to really create that sustainable and effective referral ecosystem, which is really valuable to us as part of as part of making sure that, you know, our providers were supporting our members locally to really encourage that partnership. Right? And so that's what we did as part of our goal is to ensure that members were really connecting to services and building that local referral ecosystem. Yeah. Very intentional and designed, very visible within the communities. And it sounds like with an element in a foundation of trust between the organizations, both the health Absolutely. And the organizations in which you're engaging. Ben, anything additional to add to that? I'll just underscore how important that has been. You know, we have contracts with five of the managed care plans in Los Angeles County, And I'd say Health Net has really underscored or or really emphasized from the start how important building that ecosystem is very early on, four or five years ago now. Find help, Health Net, project Angel Food were part of a speed dating event that Health Net sponsored that gave us a chance to get to know some of the ECM providers and other providers in the area. And that was actually, you know, not joking. That was a really important event that helped start planting the seeds to build those relationships. And it's an ongoing process, but I think, you know, we have a number of champion and, robust partnerships right now with places like u c UCLA Health and Cedars Sinai that allow us to both make referrals outward and, to receive them in, and that really helps, everybody in the community as well. Yeah. That's great. Thank you, Ben. And staying on the theme of highlighting the two different approaches here, I think we just heard from California the work happening with Mellon and Ben. Malika and Fanan, let's talk about the origin story of of y'all's partnership. Fanan, your team supports individuals navigating a highly complex, painful chronic condition. And, Malika, your plan is focused on building hyper local community solutions. How did you two realize you needed deeper you needed to partner with each other, and what exactly brought you to the same table? How did that initial alignment process look? Yeah. No. Thank you for the question. And and, you know, I'll start with the the headline is that, this didn't create our partnership. As I mentioned earlier, it had already already existed. And so it was an opportunity to strengthen and deepen the work that we were doing, making sure that we had an opportunity to kind of walk this journey together in the very beginning. It allowed us to learn a lot in in navigating, you know, the structure, the time frame, the, you know, cadence of how we would touch base specifically because, again, we recognize that dictating some of this work wasn't gonna be helpful. It it needed to be a conversation and some dialogue. And so that was the the way we approached it at at the very onset. I'll also share, as as we all know, you know, Sickle Cell foundation is very much a reputable organization, a trusted partner, very much boots on the ground in the communities where we are across Florida, including rural areas. And so I think some of those natural connect some points made it very seamless for us to move into this more kind of laser focused piece around the way in which we were going to be making referrals and and ensuring that we were closing loop. So, you know, what I would look at it as the early opportunity to collaborate, which is very important. And anytime you have an early adopter, you're always the ones that are able to then share those lessons learned with other partners. And so right now, we have about forty community based organizations that we work very close with, across, referrals and closing loops and making sure, again, that our members have that, continuum of of access to care and resources as it relates to health. And so, you know, that is the way that we would define our our very early partnership and the way that where we've reached to now, recognizing those state requirements, but then also just keeping top of mind. And and I think Fanon mentioned this earlier. You know, the the quantitative piece is important, but then also the anecdotal piece. You know, what did we do? What did that referral result in in terms of a positive experience for our members and in in in terms of the help that thing that they were able to receive? So looking at it, as a as truly a continuum and not just a onetime stop. And then, you know, obviously, the follow-up and the closed loop is the the critical end piece of that as well. Yeah. Fanon Fanon, didn't know if you had anything else that you wanted to add to that. Yeah. Thank you, Malika. So that's pretty much the same thing piggybacking off what she said. It's the common goals that we have for our patients, right, is the social determinants like we spoke about. And those common goals and being able to partnership created an opportunity for us to streamline our communication, care coordination for the patients, and improving our health outcomes for them, and and social outcomes as well. So being able to hear how we're experiencing the patient from the health plan's perspective and from our perspective as a CBO has been very beneficial into just creating a very streamlined process and also being able to continually evolve our processes to best care for the patients. Yeah. Amazing, Fanon. Thank you. And, Malika, both of you, I'm hearing, you know, in some regard, there's, you know, a jointly defined success. There's, you know, in terms of member experience, engagement, long term outcomes. And in order to to carve that out and to to look at that holistically and over time, there's an element of data and data strategy infused into this. Right? And so I think that's a a nice transition to a broader data and strategy discussion and how we address the the the purpose of social care data. Malika, I'm gonna I'm gonna take this one back to you here. For turning back to Florida's contractual requirement for social need screening, from a plan leadership perspective, how do you take a state mandate to screen members and translate that into meaningful local action that connects members, to the solutions? And what indicators tell you that these interventions are actually improving, the member experience, engagement, and outcomes that you're tracking? Yeah. No. Absolutely a great question. You know, while the mandate is is requiring the the screening component, the impact is something that, you know, wouldn't happen by itself. And so neither one of those two pieces can stand alone. It really is bringing both of those to bear, making sure we're doing the the screenings, the assessments, the access to care, and then ultimately tracking, you know, what is that measurable outcome. And I think that is something that we are always focused on. You know? Did we allow that member to get the care and access to what it was that they needed? And those are ongoing conversations, and and those, you know, don't always look the same across every patient, every member, every community. And so there is that opportunity to really tailor some of these initiatives and engagement opportunities. And, you know, one thing that I'll share very timely is that we've been doing a lot of back to school initiatives, and that's something that, you know, is not necessarily written out in our contract. But when we think about preparing our community, the students, and the families to get ready for back to school, we reached out to the Sickle Cell Foundation and let them know, you know, these are the free family friendly events that were happening across our communities, and please share these, you know, with with your clients as well. Because outside of of the care and the resources that we may, you know, speak of day to day, back to school time frame is is something that, you know, is top of mind. And we wanna make sure that we are addressing that need, being responsive, and and and, quite frankly, being proactive to just share that that's another opportunity outside of our our specific contractual requirements. And and then just, you know, going back to the kind of initial question, and that's just one example. I think about, you know, the state of Florida and and being in hurricane season and what we've done across the board to prepare a lot of our CBOs and let them know that in the event that a disaster is coming our way, we have some very quick response opportunities, our community connection centers being among them. But really thinking outside of that, you know, local daily programmatic piece and the outcomes that we're measuring to some of those, you know, bigger and and more timely social health related issues that we wanna be able to to combat. And so at the end of the day, for us, collectively, success and the metrics and the data really speaks to what have we done, and has that member got the help that they need? And and are we consistently being able to track that and report that and making sure that we're closing the gaps and making the referrals consistently so that no one is falling through the cracks? Yeah. Makes a lot of sense. And not too dissimilar to, I think, some of the data elements that we're seeing and hearing being tracked, you know, across health plans, across various states. Mellon, for HealthNet and in California, you're operating under CalAIM, which requires a little bit more of a highly structured data heavy approach. From a plan's operational perspective, what specific data are you guys collecting, whether we're talking about ICD ten codes, z codes, or structured referral statuses to meet, both those state guidelines and quality quality metrics? Yeah. So under Caling for community support support specifically, right, that's how we were where, what we're doing now is really using the Find Help, social care platform. Right? Because it's really critical for us to based on, you know, compliance, it's really to demonstrate whether the members are being connected to services, receiving those services, and closing the loop on that. Right? And so FindHelp is the social care platform that supports the referral management. Right? And that includes collecting referral data, tracking statuses updates, facilitating that close loop referral, and also for us was really making sure that we had integrated Find Help into our care management system, right, which is which has been very valuable for our internal teams, especially for our care managers because they can, you know, always have that information at the at their fingertips really to better track those referrals for our members and then monitor those outcomes. Right? And then if there are additional services that members are are are in need of, they can then follow-up with the members and get them connected to additional resources. And so that allows us to see where a referral is in that process. Right? And as you know, there's many capabilities in find help. Right? We also built in that ICD Z codes into our assessment process to really better document members' health related social needs. Right? So capturing the z codes helps us to really identify, you know, things like, you know, food insecurity, housing instability, transportation barriers, and other social drivers of health, right, while also making sure that we are connecting our members to the most appropriate resources. And we also use this data, you know, from find help for community support to really just to identify disparities, right, and gaps and and also gaps in access, right, with in in different populations and also regions and communities across California. And so by looking at kind of the referral trends and service data, we can really identify where those barriers are. It also helps us to really better understand the members' needs and also determine the additional outreach and support that may be needed, on our end. Right? So these these insights really help to really inform our quality improvement initiatives, strategies, from a provider engagement perspective, network development, opportunities, and also community partnerships, to, really make sure that we are, using these data in a meaningful way and actionable as well. Yeah. And I'm hearing network expansion, community partnerships, Ben, Phenom, exactly what you all do. And we know NCQA often talks about the importance of pairing that quantitative data with lived experience of patients and communities. From your side, as, you know, as providing, you know, those resources, providing those goods, providing those services, how do you balance traditional metrics such as those referrals completed or services delivered with stories and qualitative feedback that demonstrate the true impact of your work, the people that you're impacting and seeing daily? So first of all, we we just completed our, HealthNet audit, and everything Melon says is exactly true. So I I can verify that, successfully, I should have. As far as the question goes, you know, we like to say that one one of the common things I'm hearing between our friends in Florida and our case study in California is we wanna see that the work we're doing works. Right? So we like to say that we make an impact in three broad ways. One, we improve health care outcomes through intervention. We decrease health care costs, and we improve quality of life. And as a community based organization, you know, we haven't traditionally had great access to some of the data that might reflect on, say, costs. We're getting better at that. We're currently building an integration with a, health information exchange, Lanes, in Los Angeles that gives us some better information, some better data to report out to our partners and to analyze with that. We're also building an integration to find help that's going to help bring, your referral pathway into our CRM and our overall pathway. And to your question, one of the things that I think we do have great access to is seeing how our services and our partnership with Health Net really does make an impact on people's quality of life, and we hear those testimonials, and we we see them all the time. One of the things that we've tried to do with Health Net and our other partners is to regularly share success stories, that we, hear from the participants in our in our service. I remember we shared one with HealthNet a few years ago that, they were kind enough to share with some folks in their c suite, and that got some very positive reaction about how we can really see how when a Health Net member sends a handwritten note, about how our driver really makes an impact on her day and brings her renewed energy and purpose, how she's learned things from our registered dietitian and nutrition education. That really shows that the intervention is is working and that, that has been really important to be able to share with our partners as well. Wonderful. I'm gonna ask I'm gonna tie in one more question here. And for you all specifically, what information has been most valuable to your health plan partners as they evaluate program success? So maybe what are you working directly with Malika on? Yeah. So I think what's been most valuable in addition to the outcomes, right, the traditional metrics has been why those outcomes are what they are. So if we are completing the referrals because we were able to do x y z, reaching out to the patient, you know, getting the that done is obviously what we want. But when the referral may be not complete is not completed, what is the patient's experience? Is it because they're experiencing transportation or other barriers to completing these referrals? So I think those kinds of and that kind of information becomes very valuable. So we're able to complete the referrals, great. If we're not, what are this parent what is the patient's experience, and what are they, experiencing and revealing to us is why we can't complete these referrals. So there are a lot of things that come up, a lot of barriers, and being able to work through those with Sunshine Health and being able to navigate the health care system and prevent them from having, these barriers prevent their access to care and services is what I would say is probably the best thing that we're able to bridge that gap on. Yeah. Yep. Super important. And just we're hearing, you know, there's that a collaborative approach in understanding each other's needs and and where, you know, and how to best move forward to to evolve that partnership. As we move to our final two questions for today's panel presentation, we've so far heard a little bit about the policy landscape and how it's impacting and guiding staff operations, community engagement plans, and how we're addressing social care needs. We've learned about partnerships and how we engage with programs, CBOs, and the communities to really develop, build, and continue to grow the data and the collection and the stories in which we tell and how we're solving that work. And so what we do wanna do is take a moment to reflect, and have practical replication and future outlooks. And so the first question, would love to go person by person here. Melon, maybe let's start with you. If you could go back to day one of launching, you know, your collaborative partnership and just process as you described, what's one lesson learned from the health plan and leadership side or operational trade off you would have handled maybe differently? And then Malika, after Milan, will go to you. Yeah. I think so. One major lesson is that implementation takes more time and support than expected. Right? Especially when CBOs smaller local CBOs are adapting to all of the health care requirements, all of the data requirements, all the system requirements that the health plans are requiring, it's it's really challenging. Right? And when we implemented all fourteen services in the two year period, that was really a lot within that time frame. And so it's really important to build more time for workflow design and education before launching because we know that, you know, it's it's the health plan has to move quickly sometimes, and it's important because we are also on a time crunch sometimes, you know, based on the guidance. But moving too quickly can really create that confusion and really administrative burden on our partners, and we saw that firsthand. So definitely building in more time for that implementation process. Yeah. Implementation and, I would just say, more time for everything. It seems like implementation, curating and maintaining those relationships Exactly. Process, etcetera. Yeah. It it takes time to curate that very intentional and ongoing relationship. Can't be done overnight. Malika, from your perspective. Sure. And and I love this question. There's a quote that says life never stops teaching, so never stop learning. And I think that is, you know, very much applicable to the work that that we're doing. And I'll echo a a bit of what Melon said from an operational standpoint. You know, we know the nonprofits are different. We know our communities are unique. And so really taking, that step back and saying, you know, based on the capacity, based on the staffing, there's so many different factors to say it's not a a one size fits all. And the example that I'll share with you is very early on, we were trying to integrate into find help in in groups. You know, small, large, whatever you wanna call it, about fifteen to twenty, and we recognized that that wasn't necessarily the best approach. And so taking that lesson learned and and really thinking about, well, what can we do? And it was the one on one support. And so now a lot of that looks like one on one training, one on one, you know, outreach, and and really wanna thank Find Help for doing all of those additional, you know, trainings and refreshers because I think nonprofits are not unique to turnover. And oftentimes, you know, the person who may have been doing this work a year or two ago is now different. And so keeping that top of mind in terms of, well, who is the the responsible party, who is doing the referrals, and who is, you know, our liaison for lack of a better word. And oftentimes, the conversations that we have very early on to initiate the partnership and sign the contracts are not the person who's doing that day to day work. And so we wanna make sure those lines of communication are wide open. We wanna make sure that we're, you know, tailoring our support and our one on one interaction to our various CBOs and and making sure that we're being as supportive as possible and not, you know, looking at this as a one size fits all because we know that there is a lot of uniqueness across our partnerships and across our communities. And so the best way to, you know, respond and and kind of address that lesson that learned is to reassess each outreach and each partnership in terms of that, individualized support that we can offer. Yeah. And it's it's easy to get, pie in the sky early on as you're creating that social care strategy and and how you're operating and how you're connecting with the community, but love the stay nimble, stay flexible, and continue to curate that relationship on an individual basis because there's nuance there to navigate. Always is and always will be. And so, Fanon, I would love to to, same question for you all and and how you and, sorry, And what are the operational trade offs you would have handled differently? I think, when any new partnership is coming into play, you have the requirements and all of those things that you kind of are coming into. Right? Like, we're speaking operationally, how do we get this going? I think remembering that we were already doing the work, and we were just trying to figure out how to capture that it how it's being done and that full picture. So sometimes you kinda zoom in on the partnership or the new requirements, and I think that was something we learned was to remain, you know, zoomed out to the whole person and the care that we provide already and kind of integrating it versus seeing it as a shift in in our operations. And I think that would be something I would say. Yeah. Yeah. Really great. Then similar on your side, other lessons learned? Yeah. I think, to me, in in some ways, it's maybe doing even more of some of the things that we were doing. And and certainly, CalAm and our relationships have allowed a lot over the last four years, so it's on those twenty twenty hindsight. But I think, you know, investing the time, I'm so grateful that Health Net did this, to get to know the partner, to get to know what the goals are, to build those individual and personal relationships. Right? I think that's really important to get to know the goals. Like, are is the partner really prioritizing connecting with recuperative care or pharmacists or a particular diagnosis? Or I think those are all really helpful things that we can help each other to succeed. Right? And then internally, and and maybe this is kind of basic project management, but as we really making sure that we're very clear on what are the requirements, what are the deadlines, how much time do those things take, Who's accountable? Right? And I think that's really helpful, especially as we've heard some of the dynamics, in this arena are are are different. So that's good to, you know, make sure that we're tracking well. Yeah. Yep. And I think in the environment that Melon described earlier, it it's so fast, sometimes that then some of what you're talking about for added clarity and to is almost a a moment of let's slow down and take all of this in and make sure that we have all of the context and content needed to inform our operations, our decisions, our partnerships, and that's very thoughtful, certainly. Okay. And we're moving on to our last question. This one, we're gonna shift gear a little bit, to be more of a rapid fire. Thirty second response. For organizations that are looking to build a more integrated person centered social social care strategy, what is the single most important capability they should invest in first and why? I'm a switch up order here. Malika, maybe we'll start with you and then go to Mellon. Sure. You know, I think it's people. I think from the the work that we do, we're constantly thinking about people. We're constantly, thinking to our about our communities. We're reacting and and being proactive. And within our organizations and across the CBOs and across the plans, I think it is investing in the people. And and that may look different, but, you know, always being able to recognize the support that's needed, celebrate the wins, and, again, just focus on the people who collectively, the teams that are together doing this, amazing work and and making sure that we're helping our community and, you know, creating, better health outcomes. Thank you. Yeah. People. People. People. For sure. Melon. Yeah. And when it comes to people, it's really that referral ecosystem, right, which is really grounded in that trusted community partnership is what I would suggest in that, you know, investing in first. Right? Because, you know, we know that technology and data are important, but they only work if you have the right organizations and the relationships in place. And early in our implementation, you know, we learned that really the the successful a successful social care integration really requires more than just that contracting and deploying a platform. Right? So it really is required that understanding each organization's capacity and creating that clear organic referral pathway is really key and important to really establish those local relationships, partnerships, and referral pathways between those local organizations. Yeah. Couldn't have said it better. Panem and Ben, from a program and CVO perspective. I hundred percent agree. The partnerships, for sure. The needs are there. The referrals will be there. But streamlining the process and creating you know, reducing those barriers through the partnerships is the most important thing to me that we, should be investing in. And I don't wanna be flippant, but my I think my biggest advice is to do what you do well and with excellence. I mean, if we didn't make delicious, healthy meals, you know, Health Net wouldn't be interested. Right? So I think that's really important. And I think the other thing that I would say is really pride ourselves on transparency, communication, and integrity, and I think that goes a long way toward building any relationship. Yeah. Great call out, Ben. And, yes, we're all striving, I think, every day to do what we do well and to continue to do it as well as we can. And so I love that as a concluding note. Wanna appreciate and thank you, everyone. Today's panel discussion has been phenomenal. Thank you, Melon and Malika from Centene and your respective plans, the partnership from Fanon and Ben. Love to see this intersection and love to be able to share the stories where it's working really well. The impact is is evidenced, by the work in the communities that you serve. And I don't wanna steal the concluding remarks and the jump over to q and a, so I'll pass it back over to our host Joel at NCQA. But thank you, and thank you on behalf of FHIR as well. Thank you, Brandon, and thank you to all the participants for that insightful presentation. We'll now move to the q and a portion of today's webinar. As a reminder, if you still have questions you'd like to submit, you can do so through the webinar platform's q and a feature, and we'll do is do our best to answer as many questions as time permits. Right now, I see a question in the chat, and I believe this is really for all participants. The question is, have you run into challenges with CBOs being asked to use different social care navigation platforms by different partners? And if so, how have you addressed it? Malika, Mellon, wondering if this is a question best directed or answered from a health plan perspective in the partnerships that you curate, questions that you're hearing regularly from CBOs that may have limited bandwidth to hop into multiple different, systems and respond, happy to jump and chime in from a find help perspective at the tail end. Yeah. No. Thank you for that question. And, you you know, again, it it really is what we have been talking about earlier in terms of maybe not necessarily a one size fits all. And so meeting, you know, our CBO partners where they are, learning, you know, what capacity they have around technology, if any. You know, technology can be our best friend and and a worst enemy on any given day. But, you know, there is manual reporting as well. There is opportunities where we're able, as I mentioned earlier, that that support one on one to be able to work with them and and find out what some of the barriers are, if there are any, to just accessing, find help. And then a lot of our partners come to us with, you know, thoughts of other platforms that they may have access to or may be using and and wanna learn more about them. So it it can definitely be a conversation, and we love to make it, you know, very much iterative in terms of finding out what they're already using, if there's any limitations to technology, and how we can, you know, think through a plan and a system to work through, getting the information we need, supporting them, and giving them access to, find help and or learning what other platforms they may, be familiar with well. Yeah. And similar to Sunshine Health, we also understood at the beginning, right, that there would be many organizations that would be using, different platforms. And so we understood that there was going to be some of the challenge around that, and the platform that we did use was Find Help. And so what we did early on was really working with Find Help and our CBOs to really identify how we could build in that interoperability. Right? How could we integrate some of the systems and really build that interoperability so that we're sharing data between the two systems rather than having our providers use their system and then having to jump into another system, which becomes, very, takes away from the work that they're actually doing. Right? And it becomes an administrative burn on our providers. And so early on, we did look at that. We worked with our providers on a one on one basis to really understand their systems, the systems that they're using, and then working with you know, find help in a way that we could really identify what that interoperability will look like and if there's that possibility, early on to to make sure that they're not having to use two or three different systems, for this project or or for or for Cali. Yeah. And adding on the tail end there, interoperability is at the core of Find Help and how we offer our solution and how we wanna engage both with our active customers and the community based organizations that are providing those direct free and reduced cost social care services. We do offer integrations directly with the community based organizations, case management platforms for streamlined, associated workflows. And we also, as of, you know, late twenty twenty four, acquired Keap, powered by Find Help, which is a modern free case and document management platform designed for community based organizations, those CBOs and nonprofits. So we always work to support our customers and those community members where and when we can. Great question. Thanks, Maureen. You for that. We've got some more. Next, this is asking from both a health plan and a community partner perspective. How do you define closing the loop on a person's need? So I can start from a health plan perspective. So closing the loop means more than just making that referral. Right? It means confirming that the member was successfully connected to the services, that they've received the support that they needed, and that referral outcomes are communicated back to the referring entity, right, as much as possible because we wanna make sure that the referring organization or the referring individual receives the confirmation that the member has been accepted and has been followed up on. Right? And so that closing process helps to make sure that members don't fall through the cracks as Malika mentioned. Right? And it really improves that coordination between our partners, our providers, our family members, right, to make sure that they are connected to the services that they are in need of. Yeah. And and I'll just briefly add on and agree with everything Melon said. You know, the the crux of it is also the timeliness, making sure that we're able to respond very quickly to the care and and making sure that they get the help that they need. And so, again, it it really is the closed loop of ensuring that there is no gap in that communication standpoint and, that it's very much timely, and they've gotten the help and the care that they need beyond, from the referral standpoint to closing the loop. Yep. And tagging on from a Find perspective, if, the anonymous question is coming in with less familiarity with the Find Help platform, those referrals, whether it be live or logged within the Find Help instance, the expectation to demonstrate a closed loop referral would be an update to that actual referral or that navigation status. There's a variety of fields within our system that can prompt a successfully closed referral. And what the gold standard would be and what the health plan side perspective, not to speak for y'all, but assuming it would be got help, meaning they've been connected with the organization, and that member has received the services in which they were referred to. Thank you. I appreciate that. I think we have time for maybe just one more question. This next one is asking, are you surveying your members annually or quarterly to assess their social determinants of health needs and identify any changes that may be occurring due to economic conditions. This could be for anyone. It sounds like it's really especially for the health plans perhaps. Yeah. I'll I'll just chime in there and say that it's an ongoing assessment. You know, there are, reporting metrics that come through, as much as necessary in terms of as our members are reaching out for for help. And so, we're not limiting ourselves necessarily to those time stamps, but making sure that it's very much an iterative process, making sure that we're being able to respond very timely, as I mentioned earlier. And then the other thing is that communication with our partners. And so it's, again, making sure that we're connecting and collaborating and communicating all across the board, responding very timely. And then, ultimately, yes, we can track our metrics. We have several dashboards that that do this for us. So whether it's monthly or quarterly, you know, annually, we have access to all of that. But I I think the the sense of urgency and responsiveness is always top of mind as we get the referral and are closing the loops. Yeah. And then for the you know, very similar to Malika as well. Right? We have multiple touch points throughout the year, right, to really survey our members through through different assessments. And so this really allows us to really identify the changes and need as they occur, right, rather than relying on one single annual or quarterly survey. On find help, we did build a survey that's that pops up on a regular, every day. So anyone can take that survey. It helps us to really manage, the responses from community members, from our partners to really identify, you know, what those needs are, right, and to really better understand the community factors, the how economic has changed, and what we need to do to better support our members. And so it's always an ongoing survey for our members and and our partners so that we understand what the needs are, and then we can then also change over time and a judge adjust our outreach and support as, you know, the needs are changing over time. Thank you. I appreciate that, and thanks to all our panelists for sharing your insights and practical experiences. With that, I we're out of time, but, today's discussion, I'll I'll share demonstrated how local partnerships and community based collaboration can help health plans and address social drivers of health, improve member outcomes, and advance health equity. Before we wrap up, I encourage you all to join us at NCQA's Health Innovation Summit twenty twenty six taking place October fourth through seventh in Atlanta, Georgia. This year's theme, quality's next chapter, will bring together health care leaders from across the industry to explore digital quality, measurement modernization, health equity, and innovate approaches to improving care. The summit offers valuable opportunities to learn from peers, discover practical solutions, and build connections that can help advance your organization's quality goals. Be on the lookout for a ten percent off registration discount in the follow-up email from today's webinar. We hope to see you there. Thank you for joining us today. Have a wonderful afternoon. Bye. Thank you. Yep.