This blog post is part of our quarterly series highlighting the work of Healthy People 2030 Champion organizations. Healthy People 2030 Champions are organizations recognized for their work to improve the health and well-being of people in their communities and to help achieve Healthy People 2030’s goals.
For Community First Health Plans, Inc., the name mirrors the mission. As a locally owned and managed nonprofit health plan, Community First was founded to serve the residents of Bexar County, Texas — home to San Antonio — and 7 surrounding counties. To serve this large and diverse population, Community First partners with local community organizations to identify people’s health needs and overcome challenges to care. And it relies on national data and initiatives like Healthy People 2030.
Community First has identified 3 Healthy People objectives to focus on to help it build out programs to better serve its members:
- AHS-R02: Increase the use of telehealth to improve access to health services
- HC/HIT‑07: Increase the proportion of adults who use IT to track health care data or communicate with providers
- EMC‑D06: Increase the proportion of children and adolescents who get preventive mental health care in school
Expanding Telehealth to Improve Access to Care
Over the last few years, telehealth has seen a boost after COVID-19 made getting and providing in-person care more difficult. Julie Anne Eddy, Community First’s Executive Director of Innovation & Transformation, points out the technology’s potential to address barriers to care beyond the pandemic: “We serve a vast area with many rural communities where it can be difficult to find and get to an in-network provider. Even within the San Antonio metro area, many of our members experience challenges that impede access and follow-through on their care plan.”
Lack of reliable transportation and the impact of missing work are high on that list — but other challenges can also keep people from seeing a provider. “For many of our members, housing and food are their main priorities — it can be difficult to justify spending money on child care or transportation just to get to a health appointment,” Eddy says. Telehealth can help mitigate those challenges.
That’s why Healthy People 2030 objective AHS-R02: Increase the use of telehealth to improve access to health services resonates with Community First. The organization is exploring intervention options that can help increase access to telehealth for its members. Those interventions might include providing technology that people can use for telehealth appointments and identifying partner organizations in rural areas — like fire stations or public libraries — where people could access technology for telehealth appointments.
Community First is also thinking through ways to offer financial incentives to providers who offer telehealth services, especially behavioral health providers. The organization strives to provide a comprehensive approach to telehealth that includes follow-up, care coordination, and partnerships with community-based organizations.
Additionally, after the end of the COVID-19 public health emergency, Community First assessed its provider network and found that many providers continue to offer telehealth services. To support this development, the organization plans to identify ways to keep members updated on telehealth options through the member portal, text messaging services, and regular provider network updates.
Promoting Health IT to Empower Patients
Telehealth isn’t the only technological innovation Community First is focusing on. The organization also encourages members to use online databases and web-based communication methods. “We aim to show our members that their phone isn’t just for news or entertainment — they can use it to keep track of their health, send questions to their provider, and take an active role in their care. It’s a tool for patient empowerment,” says Jessica Rios, Community First’s Director of Health Equity.
This focus ties in with the idea behind Healthy People 2030 objective HC/HIT 07: Increase the proportion of adults who use IT to track health care data or communicate with providers, which is that people who use information technology (IT) to take an active role in their care are more likely to have better health. Having access to health information also increases transparency and can help build trust between patients, health care providers, and health plan providers like Community First.
But there are barriers to using health IT, and they’re closely linked to health disparities. “For our members in rural areas, insufficient access to broadband internet is a big barrier, along with a lack of technology literacy,” says Rios. “Community First is working to remove those barriers and increase technology literacy so our members can feel comfortable self-navigating their health information.” For example, Community First is providing hot spots and technology hardware to some members in remote areas. The organization also identifies local partners where members can go to access computers or connect to broadband internet.
Prioritizing Prevention to Improve Mental Health for Kids and Teens
Addressing health disparities — and social determinants of health — is also at the heart of another Community First focus area: improving the mental health of school-age children and teens. “In our service area, we’re seeing a rising correlation between mental health needs and social determinants of health,” Rios says. “We’re still working on finding the right recipe to care for our kids’ and teens’ mental health needs, but a big part of meeting those needs is focusing on preventive mental health care instead of only reacting to acute mental health crises.”
This focus on preventing mental health problems is very much in line with Healthy People 2030 developmental objective EMC D06: Increase the proportion of children and adolescents who get preventive mental health care in school. In collaboration with its parent organization, University Health, Community First is supporting a school pilot program to teach good mental health habits to kids in grades 4 to 6. The program features evidence-based, age-appropriate lessons about mental health topics, like navigating emotions and seeking help with mental health challenges. Community First is supporting the program through access to care for students who are members and are identified through the program as needing behavioral health interventions.
Community First collaborates with various community-based organizations that provide behavioral health services to elementary, middle, and high school students. “We recognize that the school setting is often the first opportunity to identify behavioral health needs,” Eddy says. “Identifying students who are at risk can prevent behavioral problems that can grow with age and time if they’re not addressed.”
Eddy shares a few lessons that Community First has learned so far on its journey to finding new ways to improve health for its members.
Dream big — start small.
“At Community First, we like to dream big,” Eddy says. “But we’ve found success with taking a gradual approach that starts with a small pilot group. That allows us to create a plan, assess our initial efforts, and make changes along the way before introducing new measures that impact our membership more broadly.”
One new initiative that highlights this approach is the inclusion of fathers in Community First’s maternal health program. “We’ve started inviting the fathers to ‘baby showers’ we host as part of the program,” Eddy says. “We found they’re just as excited as the moms about information and education on how to be the best parent possible. Our next step is to identify more ways we can include dads in this program.”
Let the data lead the way.
“Initial data and needs-based assessments are the engine that drives our approach,” Eddy says. Starting from that foundation, Community First relies on evaluating new programs and interventions to continually assess their impact and see what’s working — and what needs to change. Each year, Community First assesses the outcomes of member engagement events, programs, and initiatives to provide evidence-based information on where they’re making an impact on the health and well-being of members — and those data sets guide Community First’s efforts for the coming year.
“We put a lot of thought into the direction we take as an organization year over year,” Eddy says. “Our data is the map for the journey we take to continually improve care for our members.”
Learn from the challenges.
Eddy also highlights the important role that problems play in implementing new programs. “Challenges are the best teaching tools available,” she says. As an organization, Community First emphasizes taking an iterative approach to new initiatives, learning from what has and hasn’t been successful, and using that knowledge to strengthen its processes.
Related Healthy People 2030 objectives:
- Increase the use of telehealth to improve access to health services — AHS‑R02
- Increase the proportion of adults who use IT to track health care data or communicate with providers — HC/HIT‑07
- Increase the proportion of children and adolescents who get preventive mental health care in school — EMC‑D06