2 min read January 2023 — Community First Health Plans, Inc. (Community First) was established by University Health in 1994 to provide healthcare coverage to the citizens of Bexar and the surrounding counties. Invest: spoke with President and CEO Theresa Scepanski about its partnership with the community and other community-based organizations, the rising cost of healthcare and its role in educating community members on the significance of preventive care.
What is Community First Health Plans’ approach to healthcare and the community?
Community First is a managed care organization serving the Bexar County area, including the city of San Antonio and seven other surrounding counties. We’re wholly owned by University Health and have a provider-managed care relationship with our parent organization. We are also in similar partnerships with many other providers in our community as well as community-based organizations that serve the entire city and our members — we predominantly manage Medicaid members in our health plan. This year, we expanded health coverage offerings to include the marketplace. We are in our first year of offering marketplace plans for individuals shopping on healthcare.gov who are looking for individual plans to insure themselves and their families. We’re thrilled about this opportunity to expand and diversify in the local community.
We are also in Medicare Advantage. This is our second year offering Medicare Advantage and a dual eligible special needs plan (D-SNP), in the Bexar County area. In the last couple of years, we have been extremely busy diversifying our portfolio and enhancing our technology infrastructure. We know having a robust technology infrastructure will give us access to our membership in real time. This could be through telehealth services, as our providers are offering new methods of access to quality healthcare for our membership, or through social media by getting information out to our participants about how to take care of themselves, how to get their flu vaccines and where they can access COVID testing. There’s an array of information, and using our social media platforms to communicate and engage our membership has been very beneficial in getting immediate healthcare to our communities and families.
What is your opportunity in helping to create a more affordable healthcare system?
The biggest opportunity for us is to continue to engage and educate each community member on taking ownership of their health and ensuring that they understand the importance of preventive care. Emergency departments remain extremely busy, as we still have people who are being diagnosed with COVID in addition to others seeking emergency care. Preventive care helps reduce emergency room visits as well as lowers the cost of healthcare by preventing critical illness. We’re now in flu season, RSV, and other serious health conditions, and being aware of how to stay healthy as best as possible is vital to the individual, their family and our community. Prevention will always reduce cost because you stay out of the emergency room which may lead to costly hospitalization. Knowing signs and symptoms to get that early diagnosis can also reduce some of those costs because you’re tackling those illnesses early. Even for chronic diseases, if detected early, and you listen to your doctor and take medications as they’ve been prescribed, it will help you reduce the progression of your illness. Changing some lifestyle behaviors is also very important. Always listen to your doctor.
What are your near-term priorities?
We know that our niche is local and our goal in entering the marketplace is to offer affordable plan options to the city of San Antonio and the surrounding rural communities. Expanding and marketing the services we offer to our local community is extremely important and we want to continue to grow that particular line of business in the marketplace. We know that many individuals are eligible for marketplace options and we want to be the health plan of choice for our community in Bexar County.
Also, we are in the managed healthcare business, and working with our network providers and other community-based organizations that offer quality services has been key to our success over the years. We also know that social determinants of health are a factor in healthcare and maintaining a positive outlook on health, so we want to focus on those social determinants that impact your overall health. Individuals face different challenges and we’ve targeted four areas.
First is food insecurity. Healthy foods contribute to maintaining good health. However, we know not everybody has access to healthy food all the time, so food insecurities are one of the areas that we address for our members. Second is transportation. Sometimes you don’t get to the doctor because you lack transportation. Again, transportation to and from your doctor’s visit can be a contributing factor to positive outcomes in your healthcare. Third is housing, another important factor as we look at individuals and how they can care for themselves. Having access to a safe shelter is equally important. Fourth is health literacy. If you’re discharged from the hospital, for example, understanding what you must do when you leave the hospital to continue to take care of yourself is essential. Understanding your medications and how to take them and when to take them is extremely important. Those are the four areas we’re currently focused on.
In terms of food insecurity, we have a great relationship with the San Antonio Food Bank. They do a wonderful job, but they can’t be everywhere all the time. We wanted to do our part to contribute to those local neighborhoods where we could make a difference, so we started a food pantry initiative. To date, we’ve installed 41 pantries throughout the community, working with various local neighborhood organizations to adopt those pantries. We sponsored the construction and installation of the pantries and stock the pantry from time to time, making a difference within the neighborhoods. During the winter, we stock them with blankets, gloves and other supplies we know people need. In the fall, we add school supplies for children, and throughout the year, we include toiletries and baby diapers. We’ve been proud of not only the innovative idea to get into this sort of program in support of our food bank, but also in support of those local neighborhoods where we can make a difference in one individual’s life, which makes it all worth it.
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