Coming Home to Care for the Most Vulnerable
Sometimes, you can come home again. Such was the case for TennCare's Chief Medical Officer Victor Wu, MD, MPH, an East Tennessee native who returned to his home state to oversee care for the Tennessee's 1.4 million Medicaid recipients.
To Nashville & Back
After receiving a bachelor's degree in biomedical engineering from Vanderbilt University, Wu headed to Atlanta where he received a joint medical degree from Emory University School of Medicine and a Master's of Public Health in health management and policy at Emory's Rollins School of Public Health. He completed his internal medicine residency at Emory University and served as chief medical resident at Grady Memorial Hospital, Atlanta's publicly funded safety net hospital.
"Growing up in rural East Tennessee and then training in urban Atlanta, I saw a wide spectrum of underinsured care, which gave me a perspective on the experiences of folks across different portions of society," said Wu. "I was exposed to how social determinants of health, such as a lack of education, unemployment, and low literacy, can have an outsized impact on a person's physical and mental health."
After practicing in Atlanta, Wu spent a year as a White House Fellow for the U.S. Department of Health and Human Services and practiced clinically in Washington, D.C., as an assistant professor of medicine at the Veteran's Affairs Medical Center. After leaving the White House, he transitioned to work at Evolent Health as vice president of clinical transformation and of Medicaid strategies, leading large health systems in transforming care delivery to a population health approach.
"Working in D.C. was an eye-opening experience. I quickly learned there's such a need for physicians to be engaged in health policy conversations, within their own institution and at the community, state and federal level," Wu said. "Physicians have to be at the table and part of the solution to translate clinical medicine into meaningful policy that can be implemented with both the patient and provider perspectives."
In 2016 he returned to Tennessee to work in public service. "I looked at my own upbringing and wondered how different my life and health would have been without having parents who stressed the value of an education and a community who helped support my professional development," said Wu, noting that a quarter of Tennesseans receive Medicaid. "It's inspiring to me to come back to my home state and work with a program aimed at improving the health of some of our most medically fragile citizens."
Men's Health Initiatives
In an ongoing quest to improve men's health, Wu said the state has seen steady progress through preventative measures including smoking cessation programs. The department is also working alongside Gov. Bill Haslam's office to help curb opioid addiction, which affects a disproportionately high number of men statewide. Three Tennesseans a day die from opioid-related overdose, and the state ranks in the top 15 for overdose-related deaths. The state's multi-faceted Tennessee Together plan is comprised of legislation and executive actions and is backed by $30 million (state and federal funds) through Gov. Haslam's proposed 2018-19 budget to attack the opioid epidemic through prevention, treatment and law enforcement.
"At TennCare, we're looking to strengthen both prevention and treatment. We want to reduce the level of opioid over-exposure for first-time users," said Wu, noting evidence demonstrating significant negative downstream health impact for those initially exposed to high doses and long-courses of opioids. "Additionally, we recognize the need to reduce the stigma around individuals seeking treatment and broaden access to high-quality addiction and recovery treatment services."
Primary Care Transformation
Wu also is committed to the state's Primary Care Transformation initiative, which includes a three-part strategy aimed at transforming the delivery of healthcare in Tennessee.
"Primary care is the backbone of a healthy healthcare system, and we have to make sure we've equipped our primary care providers with the right resources and team members to get patients engaged in their care as early as possible," Wu said. "One goal we have is to recognize that patient and provider experiences are equally important. If the patient feels engaged and has a healthcare home, he or she will feel more empowered and connected. Similarly, a provider must feel prepared and supported with the right resources to meet the growing demands we place on our primary care teams."
Nationwide, patient-centered medical homes are recognized as a model of care that puts patients at the forefront. Designed to build better relationships between patients and their clinical care teams, patient-centered medical homes have been shown to improve quality, patient experience and staff satisfaction, all while reducing healthcare costs.
"Successful primary care requires so many linkages to the community. I'm eager to support innovative links allowing providers to broaden their reach and support members in their homes, schools, places of worship and communities," said Wu, stressing the importance of engaging patients outside the walls of a doctor's office.
TennCare is working with the Tennessee Hospital Association to increase communication through cloud-based care coordination tools, which allow for more data insight than ever before. "It's necessary to have a strong medical home, but how do we support a patient once the patient comes home?" Wu asked. "Being able to connect to different resources and extend care outside of the standard doctor's visit is ultimately what makes patient-centered medical homes come to life."
Wu also is focused on mental health transformation through Tennessee Health Link, which connects more than 70,000 members to behavioral health resources statewide. The response has been overwhelmingly positive and has resulted in improved data and resources to better connect practices to patients in their neighborhoods and communities, as well as foster more partnerships.
"Today we ask more and more of primary care providers who have less and less time with a patient, so we want to give actionable data and help build capabilities and reach of broader interdisciplinary care teams," Wu said, noting that 68 primary care groups in Tennessee already participate in PCMH models. "By engaging patients and providers to transform the connection between primary care and the community, we'll improve the patient and provider experience, and maximize the value of every dollar we spend by generating better health outcomes. I'm really excited about 2018 and plans we have to continue supporting primary care and primary mental health transformation."