ProMedica Q&A: Non-Clinical Solutions to Health and Hunger

Editor's note: We recently sat down with Randy Oostra, ProMedica's President and Chief Executive Officer, and a speaker at this year's Oliver Wyman Health Innovation Summit, to learn more about his non-profit healthcare system's focus on how social determinants impact consumer health outcomes. 

Oliver Wyman Health (OWH): What is ProMedica’s Mission?

Randy Oostra (RO): Our mission at ProMedica is to improve health and well-being for all. Unlike other health systems, I would not say we are an integrated system, but instead a health and wellness organization. We believe healthcare must go beyond clinical care and take a broader role in addressing social factors that affect health outcomes.

When most people think of healthcare, they tend to think of clinical and medical care. Yet, this only accounts for 20 percent of a person's health and well-being. The other 80 percent includes the physical environment, social and economic factors, and health behaviors like diet and exercise that drive health outcomes. Therefore, we are going beyond our clinical walls by focusing more attention and resources on addressing these social determinants of health.

OWH: As a provider system, what steps have you taken to better understand your community?

RO: We took our first step ten years ago when we began exploring non-clinical solutions to childhood obesity and hunger as a health issue. Last year alone, we screened over 500,000 patients for food insecurity. This year, we aim to screen another 1 million patients and will begin screening our employees. Beyond food insecurity, we are now screening patients in ten social areas that influence health and quality of life such as employment, education and a person’s living environment. Since last year, we have screened nearly 6,000 patients to better understand and help address their social needs.

Our next step involved getting more involved in our communities and collaborating with various organizations locally, regionally and nationally. For example, we recently partnered with a community development organization called the Local Initiative Support Corporation (LISC) to create a $45 million loan pool to support housing and business projects in distressed communities. Through this partnership, we will leverage institutional resources to improve community health and well-being, including revitalizing the communities we serve.

Prior to collaborating with LISC, we teamed up with the AARP Foundation to establish a non-profit organization called The Root Cause Coalition. Our goal is to bring together healthcare and other business sectors to collectively address health inequities. Since its inception, the coalition has grown to 52 member organizations and we will hold our third annual national summit on the social determinants of health this October in New Orleans, Louisiana.

OWH: ProMedica’s mission initially focused on community hunger and has moved into areas such as unemployment, schooling, transportation and housing. How were you able to scale your efforts to revitalize an entire community? What lesson have you learned and what has been your greatest success?

RO: We were astounded by hunger’s impact on a person’s health and so we have maintained our focus on addressing food insecurity. Our focus quickly evolved and expanded to address other social determinants of health. We are creating a new model of healthcare that includes not only clinical and medical services, but addresses persistent social needs that are affecting our neighborhoods and communities. We are able to scale our efforts by collaborating with other organizations and sharing resources.  

We have learned communication and pacing yourself is vital. We have had to constantly communicate to people who did not understand our mission or why we are doing what we are doing. It has been a constant education process, and there is a continual need to articulate our cause.

People have asked us, “What would you suggest we do?” and I share that attacking hunger was the right thing for us. I think it is a matter of just starting to work and figuring out some tangible things you can do relative to your resources and building from there.  

OWH: Have you seen ROI from a financial perspective?

RO: Our budget this year after launching a decade ago is about $8 million, with $7.2 million coming from grants and foundations. We invested in companies that relocated here to drive significant job growth – a great metric to see return on investment. Additionally, one of our board members, a philanthropist, gave us almost $30 million, which has grown into a $50 million investment to significantly revitalize a neighborhood. This year, we will be hiring 27 workers who will be dedicated to addressing the most critical needs in the neighborhood.

In terms of future ROI goals, we have a $25 million loan pool that we plan to grow with support to maybe $50 million, and then a $10 million grant program. We want to use this money to leverage funding, share data, provide economic development and startup work, improve infrastructure, work in distressed areas, and look at housing, schools, and job growth.

OWH: Where have you seen the most success in the community?

RO: Infant mortality, particularly in the African-American community, is a significant issue in Ohio and Michigan. We are working with several organizations in our Toledo market to address disparities in prenatal care. We have screened 20,000 pregnant mothers and through various programs and interventions, we are seeing significant reductions in low birth-weight deliveries in our target market.

OWH: What advice do you have for community provider systems across the nation?

RO: Explore what people are doing outside of the walls of traditional healthcare and look at what resources people may have that they could invest in. Get familiar with the work people are doing, and then articulate what strategy is right for your organization. Share your vision by reaching out to board members to begin discussions about your system’s role as an anchor institution and your plan to address social determinants.

While the work involved in serving as an anchor institution that addresses social determinants may seem overwhelming at first, embrace the role and start small. Before long, your system will experience successes that build the momentum needed to make a significant impact on health and well-being in the communities you serve.