Rising healthcare costs have become a defining issue for our country. The tragedy is that these costs are disproportionately driven by the neediest, most under-served members of our communities: patients suffering from multiple chronic conditions while also often managing non-medical, upstream barriers to health such as access to healthy food or stable housing.
As clinicians, we’ve witnessed the frustrations patients and their caregivers share countless times. How can we expect patients to make their doctor’s appointments if they don’t have reliable access to transportation? How can we blame patients for being “non-compliant” in their health care if they’re more worried about making next month’s rent?
Here’s the good news: the healthcare system is recognizing the importance of these upstream factors, often called the Social Determinants of Health. State Medicaid programs are increasingly asking health plans how they plan to address the social determinants of health, and the CMS is allowing Medicare Advantage plans to include social determinants-related supplemental benefits. Major health systems are aggressively investing in areas like housing and food insecurity, and employers are playing a more proactive part in holistically managing their employees’ health.
These policy changes and investments are moves in the right direction, but for the most vulnerable populations, they are not enough. For those community members, we believe that real, sustainable change can come only from within the community.
A Community-Based, Relationship-First Social Determinants Solution
At Roster, we are taking a human-centric approach to helping the neediest patients address their Social Determinants of Health. We employ community health workers — local, non-medical caregivers with deep empathy for their communities — who build relationships with patients directly in their homes, help them navigate the health system, and work with them collaboratively to address and solve their Social Determinants of Health.
We know community health worker programs can succeed. Community health workers have had tremendous impact globally for hundreds of years, and we’re beginning to see rigorous research demonstrating their impact in the US as well. The “secret sauce” of community health workers is the trusting, personal relationships they form with their patients. These relationships help community health workers gain a complete understanding of their patients’ health — clinical and non-clinical — and work in partnership with them towards healthy self-sufficiency. As respected members of their communities, these workers are uniquely positioned to develop and maintain these trusting relationships.
But we’ve also seen the challenges of operationalizing and scaling community health worker programs. Despite their critical role, community health workers have historically struggled with unstable funding sources, unclear organizational responsibilities, low technology utilization, and poor clinical integration. Executed poorly, community health worker programs can be costly and ineffective.
Roster is a team of clinicians, community health leaders, and technologists dedicated to solving these challenges. Our vision is to make best-in-class community health worker programs available to any health plan, provider group, or government entity.
We are deliberately non-clinical. This strategy allows us to focus solely on creating high-performance community health worker programs while building on our clinical partners’ existing capabilities. We’re hyper-focused on establishing tight linkages between community health workers and clinical teams, stressing the importance of community health workers having a “seat at the table” in advocating for their patients while also remaining sensitive to not impinge on clinical work.
We are dedicated to becoming the employer of choice for community health workers, who we call our Roster Health Advocates. Working closely with national- and state-level community health worker allies, we’re carefully crafting hiring, training, and management processes that empower community health workers to do their best work. All Roster Health Advocates will have full-time salaries, W2 employment, health benefits, and opportunities for continual learning and career advancement — employment elements that are unfortunately rare in the field today.
To support our Roster Health Advocates, we’ve created purpose-built technology and formed partnerships with leading non-profit, community-based, and technology organizations with capabilities in specific domains such as food insecurity, transportation, housing, and legal services. All our operations are powered by an analytical model that provides decision support for our Roster Health Advocates and rigorously tracks our outcomes. If we succeed, we will become the nation’s largest employer of community health workers, creating thousands of good, meaningful jobs in communities across the country.
The challenges of our health system are daunting but not insurmountable, and we’re more excited than ever to seeing the growing commitment to holistic, patient-centered care. Community health workers are a core piece of more sustainable and equitable care delivery systems, and we plan on being a major force driving their cause forward.
We’re always interested in finding new partners. If you’re interested in what we’re doing, please drop a line at firstname.lastname@example.org.