Welcome to Pathways
A quarterly newsletter from Waymark where we share our latest insights on technology and community-based care in Medicaid.
New Study: Waymark Signal is 90% Accurate in Predicting Avoidable ER and Hospital Use
Earlier this month, we published a peer-reviewed study in Nature Scientific Reports demonstrating that Waymark Signal, our proprietary machine learning algorithm, is 90 percent accurate in predicting avoidable ER and hospital visits for people receiving Medicaid. The study found that Signal was 3x better at identifying at-risk patients, 10x better at predicting costs and reverses the Black-White racial prediction bias in conventional risk models.
Advancing Access to Care in Washington State
In January 2023, UnitedHealthcare Community & State launched a partnership with Waymark to improve access to clinical and social care for 15,000 members enrolled in Medicaid in Washington state. A new report highlights the results of our partnership — including a 20% reduction in avoidable ER visits and 10% reduction in inpatient admissions.
A Social ACO for Medicaid Managed Care
In a new article for Health Affairs, our co-founders Rajaie Batniji and Sanjay Basu alongside Shantanu Agrawal and Sai Ma of Elevance Health propose an new model for value-based care in Medicaid: a “social ACO” that addresses social needs by placing non-clinical staff at the center of care to maximize the impact on patient health and outcomes.
Sustainable Financing for CHW Programs in Medicaid
Community health worker (CHW) programs have faced significant funding challenges — despite numerous studies demonstrating their benefits on patient outcomes and costs. In a new article published in the Journal of Community Health, we compared Medicaid payment rates for CHW programs to costs for implementing them and found that current payment rates are insufficient to achieve the benefits identified in previous studies.
Dr. John Morgan, former Chief Clinical Innovation Officer for Virginia Medicaid, Joins Waymark
We’re thrilled to welcome Dr. John Morgan to Waymark as our new Medical Lead. Previously, John served as the Chief Clinical Innovation Officer at Virginia’s Department of Medical Assistance Services (Medicaid). John will work directly with Waymark’s community-based teams and provider partners to continue providing high-quality clinical and social care for our patients.
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