As the healthcare industry shifts toward value-based care, organizations are transitioning from their traditional fee-for-service models to a world in which they are incentivized to keep patients well. With an entire community of providers joining together to deliver care, organizations must integrate communication, coordinate care plans, and manage care beyond the traditional care settings and into the community to fully address patient needs. JJ Farook, founder and CEO of InfoMC, is helping organizations successfully navigate these challenges.
Behavioral Health Roots Make InfoMC Uniquely Suited for Value-Based Care
InfoMC was founded in the mid-1990s to pioneer the use of behavioral and social determinants and community resources to more efficiently and effectively manage an individual’s health. Initially, InfoMC was focused on Farook’s passion—filling a void in the managed behavioral health field by leveraging technology to treat people with complex issues. Connecting social determinants to mental health and substance abuse—and helping clients manage those connections—was a core business model for InfoMC’s first 15 years in business.
“I watched a family member struggle to manage behavioral health issues through a primary care doctor who had little understanding of how to help people like her,” said Farook. “I believe that technology has a strong place in supporting behavioral health, because if the right information isn’t available at the point of treatment, people get lost in the system.”
When the Mental Health Parity law was passed in 2008 to put physical and mental health on par, followed by the Affordable Care Act in 2010, the spotlight was on treating high-risk, high-cost individuals. InfoMC saw an opportunity to innovate around the integration of physical and behavioral health and has been doing that ever since.
“I wake up every morning thinking about how we can help these vulnerable individuals, some of whom don’t even know that their behavioral health and personal circumstances are impacting their physical health,” said Farook. “Behavioral health needs to be part of every conversation, another disease that needs to be integrated into our everyday thinking, without the stigma that can obstruct effective treatment.”
Treating the Whole Person
Whole-person care focuses on achieving and maintaining a person’s well-being rather than fighting individual diseases. The foundation of this approach is the belief that a person’s emotional, social, mental, spiritual, and behavioral needs have just as much of an impact on their overall health as their physical body. Addressing all aspects of health, not just the physical ones that are the traditional focus, is the basis of whole-person care. InfoMC believes that this approach—integrating medical treatment with behavioral, emotional and social services—helps identify and remove barriers that make care less effective so people can get the most out of their healthcare.
InfoMC technology, called the Incedo platform, helps organizations manage how care is authorized, coordinated, and delivered so they can more efficiently and effectively care for populations with complex and interlocking physical and behavioral health conditions. Organizations use InfoMC technology to share data and automate and streamline communication and business practices across payers, providers, and community partners so that the right care is delivered to the right people at the right time to improve outcomes.
Whole-person care is especially important for those with chronic diseases and comorbid conditions, as they require a “village” of social services in addition to medical and behavioral providers to address the entirety of their needs. Collaboration must be an ongoing process that drives joint communication and decision-making across an interdisciplinary care team, with a high level of coordination to ensure treatment is efficiently delivered across disparate providers to support the big picture of care. InfoMC makes this level of collaboration possible
Managing Care for Vulnerable Populations
The impact of care management on vulnerable populations such as Medicaid and managed long-term care is huge, but funding can be a challenge, particularly for behavioral health services. Organizations can use InfoMC technology to stretch every dollar to help individuals who don’t have the means or ability to help themselves and to monitor, measure, and improve how those patients are cared for. Much of InfoMC’s focus is how to make the treatment of behavioral health more efficient and impactful for the Medicaid population and integrate it more effectively into physical health to improve the experience for both patients and providers.
One of the biggest challenges with these programs is to identify people who will benefit most from intervention—those vulnerable individuals who are the highest utilizers of care—and enroll them into appropriate care management programs that prevent high-cost emergency care. InfoMC’s Incedo technology helps organizations stratify populations to detect individuals who are high- and rising-risk and automatically trigger program enrollment. Once enrolled, completion of the individual’s health risk assessment drives personalized, best-practice plans of care to give interdisciplinary care teams a blueprint for collaboration that integrates physical health with behavioral and social determinants of health. This results in a more complete approach to care that is consistent, informed, and personalized to individual needs and results in fewer emergency department visits and better outcomes.
Another challenge is staying current in such a highly regulated, constantly evolving industry. The Incedo platform is highly configurable, enabling InfoMC’s clients to personalize their implementation to meet their assessment, workflow, program, and reporting needs. This capability enables clients to be more agile, manage multiple programs, and adapt quickly to changing business and regulatory needs, so they are responsive to their populations while remaining compliant with state and federal requirements.
“We believe that technology can be a game-changer, automating workflows and decision-making across disciplines to improve how care is delivered and how healthcare resources are utilized,” said Farook. “Our technology optimizes delivery for all types of care so organizations can use their clinical resources in the most effective way. That gives staff more time to do what they do best—caring for people.”
Vision for Future Innovation—A System of Wellness
With the fast pace of innovation in the healthcare technology space, InfoMC is looking toward the future to drive more value into the management of care. An entrepreneur at heart, Farook surrounds himself with people that have that same spirited mindset and passion about making a difference to the health of the populations they serve. The InfoMC culture drives innovation and excellence at all levels through collaboration, trust, and empowerment, enabling the delivery of quality products and services with the highest standard of customer satisfaction. “Our work is not about selling software—it’s about helping our customers improve lives,” said Farook.
Today, one in 10 individuals cared for by InfoMC’s clients are influenced by care management, typically the most vulnerable and complex populations. Seeing the impact care management can make for high-risk populations, InfoMC wants to apply the model not just to the riskiest patients, but to the population as a whole—because the other nine individuals not under care management may end up as next year’s costliest patients.
“Our vision is to take the model we’ve built at InfoMC with a small but impactful population and expand it not only by reaching more organizations, but by leveraging the solution with our existing clients to benefit more patients,” said Farook. “Many people, not just the most complex, have interconnecting medical, behavioral, and social issues that affect their health. Figuring out how to find those rising-risk individuals and making sure they stay well—i.e., developing a system that is proactively focused on wellness instead of just reactively treating the sick—is how organizations can really make an impact.”
Farook acknowledges that changing the mindset to focus on wellness is challenging for many organizations. Because members switch health plans, health plans are not incentivized to think long-term. “Investing in the future means that you do the right things for the health of each individual today, and outcomes will improve across the board,” said Farook. “We need to find a way to push the ownership of health back onto the individual, making each person accountable for his or her own wellness and care.”
InfoMC is doing its part to innovate so that its tools help drive this change. The company is making it easier to connect with patients so that engagement is meaningful and efficient, removing siloes and integrating data to make collaboration harmonious and informed, and automating processes to free up staff to engage in preventive care. The company believes that this work will pave the way for wellness-focused whole-person care that will improve outcomes for all populations and empower each individual with the tools they need to self-manage their health.
“We are passionate about working with our clients because they understand the value of prevention in creating the best outcomes,” said Farook. “Our mission is to build technology that makes this possible.”
Inspiring the Next Generation of Entrepreneurs
Farook believes that healthcare, particularly care management, needs more entrepreneurs. More companies doing care management creates more competition, he says, which leads to more innovation that will benefit the consumer and ultimately lead to better care.
He has two concluding pieces of advice for entrepreneurs:
- Don’t start with a big vision and mission—break it down and add to it later. Start with your passion (as Farook did with behavioral health) and grow from there.
- Culture is critical. Find and bring in people that share your passion. Otherwise, it’s an uphill battle to achieve your goals.
“As entrepreneurs, we take risks, but they are calculated risks because making the wrong move will hurt not only our employees and our customers, but our customers’ customers,” said Farook. “At the end of the day, it’s about doing the right thing and doing it well to improve the lives of over 25 million people our clients serve.”