This episode explores Waymark, a healthcare technology company aiming to transform Medicaid care delivery. Against the backdrop of rising costs and inadequate care for Medicaid recipients, Waymark presents a community-based solution. The company utilizes a machine learning model, "Signal," to identify patients at rising risk of acute care needs with over 90% accuracy, enabling proactive interventions. More significantly, a New England Journal Catalyst paper details Waymark's success in reducing emergency room visits and hospitalizations by almost 25% while improving quality metrics. For instance, the intervention focuses on addressing social determinants of health and patient-defined goals, leading to a two-thirds success rate in achieving those goals. The company's structure as a Public Benefit Corporation (PBC) underscores its commitment to social impact alongside financial sustainability. What this means for the future of Medicaid care is a potential paradigm shift towards proactive, community-integrated, and data-driven approaches, demonstrating the effectiveness of combining technology with community-based care models.
