Pear Suite, a digital health company that empowers community health workers (CHWS) to address social health determinants, is building a network of growing suppliers in association with health plans.
In the last ten months, Pear Suite has been associated with seven health plans to recruit more than 1,000 CHW suppliers of more than 200 community organizations, expanding the ability to serve more than 11 million Medicaid lives in three states. Simultaneously, Pear Suite has hired eight additional plans of the Medicaid and double eligible double (D-SNP) special plan to implement CHW suppliers in communities where they are most needed.
Pear Suite says that its platform with AI continues to evolve, providing significantly higher value than the CHW, the maners and other first -line health workers, many of which are in transition of paper evaluations and spreadsheets. Pear Suite currently supports organizations in 25 states, with a rapid expansion planned by 2025.
In a 2024 interview with Health innovation, Colby Takeda, co -founder and executive director of Pear Suite, said that her organization is helping CHW, promoters, health representatives, Doula and others evaluate and address the social promoters of health. In California and other states with CHW benefits sponsored by Medicaid, Pear Suite has also supported the CBO in managed billing care organizations for qualified CHW services.
As the software solution was created, the state agencies were beginning to implement the ChW refund for Medicaid. «That was a good time for us, because Medicaid reimbursement had data monitoring requirements and had compliance and audit requirements,» Takeda said. «You should be able to send claims that are based on Z codes. So we actually create support for all these tools and now we support community organizations in their turnover,» he added. «For many of these groups, move from nowhere to receive your work has been enormous.»
Pear Suite is looking to help CBO with other cases for the use of data exchange. Initially, health plans are the managers and facilitators of the benefit of CHW, Takeda explained. Of course, they want to link this benefit with their care gap closures in their population’s health initiatives. «Now we are sharing a bit of such data between health plans and community organizations,» he said. «The next step after that is to obtain data from the health system so that we know who is discharged from a hospital or an emergency room or has specific types of treatments to which they have to connect.»
A non -profit organization based in Hawaii who has become a pear suite user is Na Hoaloha on the island of Maui, whose work that connects people with local resources became even more crucial after the devastating fire of Lahaina in August 2023.
“We have been involved with Pear Suite for about four years. Just after the pandemic began, they were very fundamental to bring together all medical care providers and non -profit organizations in Hawaii to focus on food insecurity, «said King Van Nostrand, executive director of the organization. Pandemia, and we have been growing with them since then. «
Na Haloha’s work becomes even more challenging after Lahaina’s fire. «Our work became dramatically dysfunctional after fire,» said Van Nostrand. “We still take care of more than 137 participants who were in the fire zone that had to be relocated. They had to readjust with absolutely nothing in their hands or pockets. ”
«Our people are much more isolated,» said Kathleen Kenney, Na Hoaloha’s browser, which helps connect people with the care they need. “They have lost their natural support system and their friends. A person told me he doesn’t know where none of his friends are. It has been more than a year, so those things are really heartbreaking and really impact people’s mental health and only their general health. «
Instead of having a folder with a stack of papers on his desk, Kenney now has a system to track each meeting and reference on each client. «Anyone with whom I find, I do a reference survey, and all that is documented in Pear Suite, and then there is a two -week follow -up, a quarterly evaluation and a six -month evaluation,» he said. «All of that generates data, which show, hopefully, the positive impact that a browser or community health worker has to improve the lives of people who live independently, and that helps to demonstrate the need for future position and financing, of course.»
«Kathleen has made a big difference in our business,» said Van Nostrand, «because we are present.» Not only are we behind a wall or behind a door or a phone. We are there in the community and discover exactly what we need to know to help try to solve someone’s problems. Our business is changing weekly, and we need to have support and tools that are easily adjustable, that are fluid and can grow with the times. And we find that when working with Colby and the community of Pear Suite, we have that flexibility. «
The company said that members of the Pear Cares Supplier Network also benefit from clinical, operational and administrative support, including the review of the care plans, claims management, policy training and compliance assistance, key areas that often present significant challenges for community organizations.
Health plans are also benefiting from the Pear Suite software, since they are eager to simplify the accreditation, hiring, compliance and reports for CHW, while raising their skills and experiences, the company said. The network also offers comprehensive educational resources, regular training opportunities and a solid community to share best practices and collaborate.
«The final objective of the Pear Cares Supplier Network is to increase the use of Chw Preventive services while they break down the inherited barriers that have limited the limited CHW to associate with health plans,» Takeda added in a statement. «In doing so, people with unattered social and health needs can really benefit from the knowledge, skills and experience of Chws, an underutilized workforce that has proven to be exceptional in closing care gaps in a culturally sensitive and person -centered way.»
As one of the first most early partners of Pear Suite, the California Health Network, a Medi-Cal Managed Care Organization and a Centene subsidiary, has been associated with Pear Suite to recruit more than 300 CHW to support its state membership of 1.6 million.
«Community health workers play a vital role in closing the gap between medical care systems and our members, helping to ensure that they receive services related to perinatal care, preventive care, transport, oral health, aging and much more,» said Dorothy Seleski, senior vice president of Medi-Cal in the health network, in a statement. «Through our associations, we can empower members to take care of their health, which finally leads to improve health results and reduced disparities.»
As the Pear Cares Supplier Network expands, Pear Suite said it would continue to forge new associations with a wide range of health plans in all commercial lines, including Medicaid, Medicare and commercial insurance.
