Sachin Jain, MD, opened a homeless clinic in 2001 while he was a student at Harvard University. The clinic operated for three years and Jain continued at Harvard Medical School. Since then, he has served in the federal government as both a founding member of the Center for Medicare & Medicaid Innovation and a senior leader at the Office of the National Coordinator for Health IT, as well as in private sector roles, including chief executive at CareMore Health.
Today, Jain is the CEO of SCAN Group and Health Plan, which established Healthcare in Action, a medical group specifically for individuals in Southern California’s senior population who are experiencing homelessness.
Health Evolution Editor-in-Chief Tom Sullivan spoke with Jain about the grand vision of solving homelessness, how his experience working on the problem earlier in his career informed Healthcare in Action, and the human element necessary when treating one of the hardest populations.
What inspired the Healthcare in Action medical group?
Jain: As an undergrad, I volunteered at a Harvard Square homeless shelter in Cambridge. I worked the post-dinner shift, which was great because you cleaned dishes and ended up speaking with folks. I got to know individuals who were experiencing homelessness and it was striking how many had suffered from homelessness because of health care issues and how much it exacerbated those.
So, I started a homeless health clinic with the Cambridge Health Alliance and established a new homeless health site. Working in the clinic, I learned the basics of supporting that population, how important building trust is and how significant the barriers are because people with mental health and addiction issues are often mistreated in emergency rooms and other care facilities. Then a few years ago when I was at CareMore and looking for an inspirational speaker, I contacted Jim O’Connell, the founder of Boston Health Care for the Homeless Program, and asked him to participate in a plenary fireside chat. While I was interviewing him in front of our 3,000 associates, there was a eureka moment that prospective payment models are a solution to homeless health care because we can allocate investments to avoid ER visits, ICU stays, unnecessary hospitalizations such that Medicare Advantage could be a vehicle for addressing homeless people. We presented it to [then CMS Administrator] Seema Verma and discussed with Brad Smith of CMMI.
Then when I came to SCAN, it was evident that we had to make it real. We just needed to start the work so we decided to build the medical group founded on intensive outpatient management to avoid expensive care. Mike Hochman was a year ahead of me at Harvard Medical School and a key person as I got to know the LA health care community. So we recruited him to lead the group.
