Jaffer Traish is COO of Findhelp of Austin, TX.
Tell me about yourself and the company.
I’m the son of two parents who grew up in poverty. One parent lost two siblings due to food insecurity. At 15, I became a community organizer, working to improve the health of families living near old power plants. Over the years, I’ve worked in government, health IT, and advisory, My focus is on improving the health and wellness of the vulnerable. Our CEO also had many experiences that led him to found Aunt Bertha, now called Findhelp. He worked on streamlining benefit enrollment in state government and became the guardian of a relative who had a rare disease.
The mission of Findhelp has remained the same since founding, to connect all people in need to the programs that serve them with dignity and ease. We are focused on the social drivers of health, such as food, housing, transportation, and other human services. We work every day with communities and government to modernize the social safety net of health and human services by providing open, focused, and contracted social service networks and integrated software for healthcare plans, employers, education, government, and community organizations. We are seeing something interesting happen. Nearly 1 million new adults use the network every few weeks, and that’s humbling and sobering.
Our US healthcare model is an world outlier in being very much driven by profit. What are the challenges in creating a safety net and connecting people to it?
There remains enormous friction in the way people apply for benefits, determine their eligibility, and source post-acute care, social care, and placement. The social service sector and the post-acute care sectors are just catching up to the age of digitization and basic interoperability. It’s interesting to see the first White House Conference on Hunger in 50 years and some new investments, like broadband investments, that are showing some greater federal attention to the safety net. There are more than 240 bills in Congress right now with social care components and over 80 with health equity components, though still today, public policy is slow to address root causes of disparities. With a mostly private-funded safety net, it’s difficult to achieve that scale under our current program.
In terms of the role of government, there are waivers in 23 states with social care reimbursement elements. We believe that government can fund capacity of services, streamline enrollment, require reporting, and accelerate interoperability certification, though they should offer guidance to states on this work and not necessarily suggest paying vendors large sums of money as as solution to social drivers of health.
What is the effort involved in finding hundreds of thousands of programs and maintaining their information?
We call that team our human curation team. It’s hard work. Our team is on the phone every day talking to service providers across the country, validating important information such as the languages they support, eligibility rules, and sliding scale cost structures. We believe that providing individual seekers the dignity of being able to explore their own options is important in this country to empower individuals to find the best services. That information has to be as accurate as possible, as they don’t have the luxury of extra resources, and we want to build the best connections for them to those providers.
That team is our largest investment in the company. We believe that some degree of automation is important and can help us in that curation work, though we receive thousands of signals every day about how programs change and our team is responsible for reviewing, vetting, and processing that feedback. That’s a commitment that we have as a public benefit organization to serve the country and ensure that we make Findhelp.org a free service to the nation.
The network is important. On top of the network, we provide, on the private sector side, the software and tools for care coordination to support connectivity between private industry and the social services sector.
We’ve seen a lot of non-profits engage with us because it helps them with their overall operations. Most folks don’t know, but we provide free case management tools to non-profits, and when they sign up with us for no fee, they have the ability to publish their appointment slots. They can run reports to show their funders how they are serving people. They can see who’s using search terms to find their organization. They can publish an eligibility screener so they can automatically respond to people to let them know whether they qualify for their service or not. They can even integrate referrals into their own non-profit system of record so they can continue working in their own workflows.
What is your business model?
Our business model is relatively simple. We didn’t want to take the approach of traditional health tech companies and charge user licensing or have a PMPM model because that restricts the number of helpers that can engage in this work and the number of people that can self navigate. Early on, we decided that we would have a simple annual subscription model to the software and to the network to integrate and embed into your own navigator workflows. That has been quite appealing to healthcare, government agencies, community colleges, and even large employers who have come to us to help their employees.
Each industry has their own drivers for why they sign up. Some, it’s financial. Some, it’s recidivism. Some, it’s clinical outcomes, student retention, and so forth. The broadness of the network appeal creates a network effect, and that’s why we are seeing somewhere around 50 new large systems join us every quarter right now.
What is the role of the health system that joins?
For our customers that have helpers — and this could be a social worker, a discharge planner, or a navigator of sorts — they are quite interested in assessing individuals for their social needs, generating outbound connections, referrals, or applications to the non-profit sector. Even ordering goods and services, which is something that has emerged in the last couple of years, like diapers or car seats for a new mom to leave the hospital on time. They are interested in building these connections and even funding and supporting some of the service delivery for those connections.
They are interested in tracking the service delivery outcomes and eventually marrying that information with their own clinical or cost information so that they can begin to study the impact of doing this work at scale within their populations. Integration is a key part of their vision. For example, our bi-directional referral integration with Epic’s Compass Rose is a big investment to bring smoother workflows to these tens of thousands of navigators.
What does that integration look like to an Epic user?
We’ve built four integrations with Epic to meet customers where they are in their investment into social care. The first is to give dignity to the population, and that is an integration with MyChart. That is where customers like Trinity Health have embedded their social care network directly into MyChart so people can self-navigate and self-refer to programs at scale. That’s tremendous, by giving people the dignity of access.
The next integration is bringing the network live as a SMART on FHIR application embedded into the care navigator’s workflows. With that integration, navigators can send referrals, process applications, and text and email program information to people who may not be ready for a referral and otherwise navigate the entire network.
There are advanced customers who want to leverage Epic Healthy Planet and Compass Rose to natively have the network living inside of the Epic tools. That’s where the integration is using APIs to allow helpers to directly surface information about programs and send referrals bi-directionally to the non-profits without ever needing to use our software.
How did your work change during the pandemic?
We saw over 100 healthcare organizations join us during the pandemic. We saw major EHR companies reach out to us to accelerate the development of this integration. We added around 4,000 COVID-19-specific support programs to the network during the pandemic. We saw significant volume increases around the country of people looking for help and of navigators using the network. We were up late at night for more than a year working hard to improve the system scaling as well as the software features to support such growth.
How does United Way’s 211 program integrate to support people who lack broadband access?
There are around 240 different 211s around the country. We think the work they have been doing is incredible over the years. Many of them operate call centers, and that’s the first place many people think to call when looking for a service.
We view them as complementary to the work that we do in many communities. In fact, we collaborate with more than a dozen 211s around the country, and some of them are actually our customers. We see the potential for 211s to not only operate as hubs in communities, helping with care navigation, but also being able to collaborate on the program network and the quality of the program information, as we often both do that curation process in communities. I think there’s an evolution of the 211 model that we are seeing happen around the country.
KLAS has reviewed the small market of social determinants of health networks, in which Findhelp earned top scores. How do you see that market evolving?
We were doing this work 12 years ago, before the term “social determinants of health” was a buzzword. We called it “poverty alleviation.” There were around 15 companies in this space. Over the last 10 years, most of them were either acquired or closed up shop.
It’s interesting because we see three key issues coming to light. The first is privacy. How do we ensure that individuals can control their private referral information and share it when they are ready and not force an oversharing model? The second issue is interoperability. Are we willing to make the investment as a company and integrate and interoperate with the right systems around the country? Third, how do we work with government? Do we enable government agencies that have helpers to do this same work, or do we depend on government funding to build infrastructure? Our approaches to those three have resonated with many industries, including healthcare. That’s what I would attribute our momentum to, alignment with those that are doing this work to those principles.
What developments do you expect to see over the next few years?
Software is only a small part of building bridges between healthcare and social care providers. Our most successful customers are in the community with us, building trust with the service providers, hiring community liaisons, and organizing coalitions. That is real network building. We are going to see a plethora of funding, and we must be mindful that we direct that funding as much as possible to capacity of these service providers, who are the ones doing the hardest work to serve our communities. That’s where we should keep our focus and attention, serving the service providers and the navigators that do this work every day.
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