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New Disrupter Aims to Complement Hospitals with Cultural Competency

Cultural Competent Care

For decades, harm reduction clinics have been working with healthcare consumers on the fringes of society.  Harm reduction embraces a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. This “under the radar” aspect of the American health system may have gone unrecognized by many, but almost a decade ago, United Nations Secretary-General Ban Ki-Moon acknowledged the value of organizations that provide such services, saying, “No one should be stigmatized or discriminated against because of their dependence on drugs.” Now, instead of working from the fringes of the healthcare system, disrupters like BOOM!Health in New York City are setting the bar for coordinated, culturally-competent care, aptly demonstrating that you can have a positive impact on high-risk, marginalized patients on a modest budget.

Why BOOM!Health is Turning Heads in Healthcare

The focus on shifting from fee-for-service payment models to quality, value-based care means that organizations like BOOM!Health, with its proven experience at providing coordinated care, are moving into the spotlight. A recent Kaiser Health News article reports that “state-based health reforms, coupled with new incentives put in place by the federal health law, have improved the clinic’s prospects.”

Created in the merger of the Bronx AIDS Services and CitiWide Harm Reduction in 2013, BOOM!Health was launched based on an integrated healthcare delivery. Now its harm reduction services are provided in conjunction with primary care, preventative and behavioral health services. This care model is rounded out with an on-site pharmacy to facilitate medication management and assistance with connecting patients to needed services ranging from nutrition counseling or legal aid to affordable housing for the homeless. The effectiveness of BOOM!Health has attracted the attention of the New York Academy of Medicine which suggested that clinics across the country follow BOOM!Health’s example.

KHN interviewed Robert Cordero, the outgoing president and chief program officer for BOOM!Health, to learn more about this disruptive care model that aims to deliver culturally-competent care to an oft-overlooked population. He offered these insights:

  • Organizations like BOOM!Health can help hospitals bridge a gap. Marginalized patients, like those with addiction or mental health issues, are among the highest utilizers of the Medicaid system. Yet, as Cordero points out, “Hospitals aren’t good at going out into the community and finding people in shelters.” Community-based harm reduction clinics are more intimately involved with those individuals, empowering them to connect patients to the right types of services and support that can keep them out of the ER.
  • Harm reduction centers often struggle for funding, making it difficult to find extra funds to invest in health IT systems. Subcontracting with a local hospital and a federally-qualified health center, along with focusing on coordinating care and demonstrating measurable gains in positive outcomes, has allowed BOOM!Health to generate a steady revenue that supports their mission and funds development of the data system and health IT tools they need.

Ultimately, the mutually-beneficial relationship between BOOM!Health and Bronx-Lebanon Hospital Center also benefits patients who otherwise would face many barriers navigating through complex health problems.

How Can Your Hospital Achieve More Culturally-Competent Care?

As the BOOM!Health success story demonstrates, collaboration is a critical component to providing culturally-competent care. Hospitals represent just one of many types of organizations serving communities. Often patients who are marginalized — due to addiction, a language barrier or some other reason — turn to more familiar, less intimidating resources within the community. By cultivating more partnerships with these organizations, hospitals can better understand community needs and develop care coordination models that support both mandated reforms and patients who previously fell through the cracks. Furthermore, with the help of psychographic segmentation, hospitals can identify better ways to engage and motivate individuals within these marginalized groups.

For example, based on the 2015 c2b Consumer Diagnostic, Willful Endurers appear more often across all ethnicities. They are self-reliant, reactive to healthcare issues, and more prone to addiction, yet they are brand loyal; once they find a product/service/entity they trust, they tend to stick with it. Willful Endurers also respond to different messaging and approaches versus other psychographic segments. Given these propensities, a hospital might look to coordinate with community pharmacies as a link to these patients. Armed with similar insights into how psychographic segments vary, hospitals and other healthcare providers can provide more culturally-competent care that connects with patients and achieves better outcomes.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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