Transforming Medicaid Care Delivery


Following the Medicaid Innovations Forum in Orlando, FL, our team walked away with the sense that healthcare as we know it continues to undergo tectonic shifts in how it’s being served up, selected and delivered; payers and vendors scrambling for a solution to overcome the social determinants of health and measurably improve health outcomes in a system that is primed for change. Our mission, to improve patient outcomes by organizing and acting on real-time health data and insights, is driven both by technology and the clinical pharmacy experience amassed across our organization. By combining our expertise in clinical outreach with digital health tools, remote monitoring, and care management, we have so many ways we can help patients take charge of their health.

Thought Leadership Innovation

Our VP, Clinical Operations, Carmen Fusselman joined an esteemed panel who explored the topic of innovative virtual care initiatives for Medicaid beneficiaries with expanded access to care, convenience, and cost savings. Discussions centered on the benefits and challenges that Medicaid beneficiaries face as telehealth, remote care delivery, and hybrid in-person care models become more prominent within the Medicaid care ecosystem.

Carmen shared the Custom Health vision of transforming the care experience for patients at home while helping those who take medications have the best possible health outcomes. Our operations utilize hundreds of health care professionals across the nation who connect with patients at home to help them manage the complexity of their health conditions and medication regimens.

Outcomes and Telehealth

The availability and demand for telehealth services has exploded since the public health emergency declaration in 2020, especially amongst several key Medicaid demographics, such as behavioral health patients in rural areas. However, with that order soon to expire due to the end of pandemic-era policies and public concerns about cost, there was a real sense of worry amongst many at the conference. Out of this, we were reminded that as an organization, we’ve been pioneering telehealth as a solution to lowering healthcare costs and improving outcomes since before the rise of telehealth.

Patients are engaging with providers via telehealth as a viable alternative to traditional health care models in the post pandemic world. Medicaid organizations adapted and shifted to address barriers to care, delivering services to members directly and addressed needs as gaps revealed themselves. Coming out of the public health crisis, those gaps are being identified and addressed with advances of technology. Technology has streamlined the process for patients that desire an at home experience and systems recognize that this need stems from barriers to accessing to health care services and equity to improving the quality of care.

Opportunities Abound

The Custom Health team left the Forum feeling that the opportunity to influence major determinants of health by leveraging technology is available across the US today; it's just a matter of applying it. Our own research has demonstrated and there is growing evidence that individuals are ready to accept care designed for their unique health needs, customized for them and delivered remotely at home. We are inspired to continue to scale our services that we know will have a broad impact and reduce costs in delivering care through innovation that enhances care and improves equity to health services, even for the most complex of populations. The team will continue to look for opportunities to demonstrate the ways that Custom Health can influence and improve health outcomes through proactive care, all while allowing members to remain safe at home.

We utilize hundreds of health care professionals across the nation who connect with patients at home to help them manage the complexity of their health conditions and medication regimens. By combining digital health tools, remote monitoring and care management, we make it easier for patients to manage their health conditions and take their medications appropriately.

Carmen Fusselman, PharmD, SVP Clinical Operations

About the author

Carmen Fusselman has more than 20 years of pharmacy management experience along with countless hours of direct patient care. She has a wealth of pharmacy retail, operations, clinical and healthcare business expertise and is an accomplished leader with a history of continued growth and development of pharmacy businesses. She led our clinical operations with a focus on operational excellence and innovative solutions for some of the most challenging and complex programs.