Radical Transformation: HealthBegins' President Looks Ahead at 2018

Dear Partners,

​2017 was a remarkable year. Its impact is illuminated in this story told to us by Dr. Barbara Rubino, a medical director for primary care at the Los Angeles County Department of Health Services. ​​

​About two years ago, I saw Rishi deliver a keynote address. He spoke about screening patients for housing insecurity and dared the several hundred of us in the audience to try it. I thought there was no way we could do this at our hospital-based clinic. But then, as the months passed, I kept recalling his charge. Maybe I’d be bold enough to try some of the work that HealthBegins explains could move us upstream.


With a lot of collaboration across disciplines, training, education, and ongoing improvement, two years later we screen all our primary care patients for a variety of behavioral and social conditions that affect their health, including housing insecurity. HealthBegins was our original inspiration to address social needs, and now it is a vital force in supporting us as we refine our processes to track patients and assure that they’ve reached the resources they need.


The radical transformation Dr. Rubino describes is the same one we’ve been seeing across the country this past year. From medical directors and health plan executives to senior managers and frontline staff, nearly all our partners and clients have endorsed the same epiphany:

Moving upstream to improve care and the social influences on health is not only necessary — it’s possible.


The significance of this mindset shift is hard to overstate. Many, including me, have long dreamed of a society where our health and social sectors are seamlessly connected, where they collaborate to reduce illness and build the health of individuals and neighborhoods — especially for the most vulnerable and disenfranchised among us.


For many years, progress toward the dream of upstream medicine seemed elusive. That is, until 2017.


As detailed in our 2017 annual report, you’ll see that a growing number of bold leaders in health and healthcare, supported by our Upstream Quality Improvement approach and our tools for cross-sector collaboration, are making upstream care a reality. They lead Medicaid health plans, such as Inland Empire Health Plan; drive transformation under federal initiatives, like the CMS Accountable Health Communities model; remodel large health systems like Providence St. Joseph; and radically improve care at community health centers such as Hayward Wellness Center. Health systems that previously considered social needs out of scope are now partnering with social and public health to treat these needs as addressable conditions. Each one shows others that moving upstream is possible.


​As we look ahead to 2018, the entire HealthBegins team and network of experts is excited to inspire and enable more trailblazers like Dr. Rubino to make their own radical transformation toward upstream care. Have you tried to turn the tide at your organization yet? If not, let’s be bold together.



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