Utilize Health helped a Nashville couple recover after being affected by a tornado, a process that included helping members access the medications they needed to manage their TBI.
Leverage your health
Utilize Health explains on its website that it “(improves) the health and well-being of people with neurological conditions while reducing the overall cost of care.” The company promises a holistic approach to care management, saying it offers “a better way to manage complex neurological conditions from diagnosis to chronic phase” through personalized programs designed with “comprehensive risk tools and care plans.” In short, Utilize Health is firmly committed to being there for people in this world-changing moment that they characterize as “a world where there is endless information without maps or directions.”
The mission of Tennessee-based Utilize Health resonates deeply with Christine Black. Black, who serves as the company's vice president of business development, explained in a recent interview that she serves as her husband's caregiver after he suffered a “severe spinal cord injury” and became “a quadriplegic who required a ventilator.” This lived experience makes her unique in that it gives her an up-close look at what neurological care is like in everyday life. Black reiterated Utilize Health's mission, saying the company is a “care management company that supports people living with complex neurological conditions,” including stroke, traumatic brain injury and spinal cord injury.
The driving force behind Utilize Health's work is providing a solid plan of action for patients who receive a neurological diagnosis in the hospital. Black says that what often happens is that the diagnosis is communicated while the patient is in the hospital. The challenge comes after discharge, at which point, Black says, “the responsibility for navigating it all falls on the individual and their family.”
Indeed, the “everything” can be just as overwhelming as the diagnosis itself: insurance, medications, financial constraints and, Black says, “other pieces of the puzzle” that can get overwhelming without the right support. Utilize Health wants to be that buffer.
“We don't have a large enough case management team to help them,” Black said of the challenges facing patients and their families who need stronger support systems. “There's a lot of nuance in the condition itself, so there are so many different factors at play: social determinants of health, functional needs, people need the help they're not getting from their health care providers.”
Black's opinion is no exaggeration or hyperbole. She says Utilise Health has spoken to both patients and healthcare providers (including primary care physicians and specialists) to identify problem areas in the field. For patients with neurological conditions that require complex care, “there is a big hole in the market,” she says. Given her husband's needs, Black feels that gap keenly.
“I acknowledge the need for care coordination,” she said.
Black said that like most things in digital accessibility, Utilize Health could exist in another world where technology and the internet are less dominant, but the reality is that it can't function “as effectively” without it. Technology has opened many more doors, not just in terms of access, but the rapid increase in information and connections. Utilize Health can function because everyone is so interconnected now. Black also noted that the company is developing tools to address depression and other co-morbidities. A key part of the role of technology in Utilize Health's operations is sheer scale. Without access to tools like electronic medical records (EMRs), the company's effectiveness is hindered. And that says nothing about accessibility for the likes of Google that help families find services like Utilize Health for their loved ones. As Black highlighted, a big drawback is that Utilize Health currently only operates in Tennessee.
Black said that for Tennesseans who need help with neurological conditions, Utilize Health is “the option” when it comes to coordinating care at scale. There are companies that do similar things, focusing on kidney care and cancer care, but Black said for people living with “acute or chronic neurological conditions,” Utilize Health has the ability to support these people comprehensively.
When asked about the feedback, Black said it has been “positive,” adding that Utilize Health has been praised for improving “self-reported anxiety and depression scores” as well as helping with important socio-economic needs like employment, housing and food security. Utilize Health's care managers are an integral part of people's daily lives, and Black described them as “trusted advocates helping people reach better health outcomes.”
As for future plans for Utilize Health, Black said the company is looking to sign contracts with more health care plans, such as Medicare Advantage, to expand coverage. More broadly, Black hopes that people with neurological needs will be “given more attention” in terms of care and stronger support. She openly shared her own personal experience, saying that even though her husband is “highly educated” and has family members in respected professions such as doctors and lawyers, it was “a real struggle” for him and his family to accumulate the resources they needed. Black and her family struggled to get her husband care in the form of visiting nurses. It is easier for Black and her family to pay for concierge home care because her husband's needs are so extreme that it would be rather impossible to get him into community care. This means that it is difficult for Black and anyone else to “address all of his needs.”
“If we as a society can aim to provide care that considers the whole person and their family – care that suits the person wherever they are in the home – then we will have a better experience of care overall,” she said.
Black continued, “A lot of health plans that I talk to have very strong case management and care management departments, but the problem is that members don't trust the plan because they're denied various services by the payer. I think companies like (Utilize Health) and other companies that do external care management can add value by being the trusted source. I think it's in the (health) plans' best interest to separate care management from other plan offerings because, as I said, it's the plans that make the big decisions about approvals and what their members need. Members often hide information or don't want to work with the plans because there's a push and pull between the members and the payers. Care management companies like us can add a lot of value by being the trusted source for members.”
