New Orleans Gun Violence Prevention | Public Health Documentary

Some projects stay with you, and this one did. We traveled to New Orleans to document a genuinely first-in-the-nation idea: treating gun violence as a public health problem and funding the prevention work through capital markets, rather than leaving it to law enforcement alone. New Orleans is an incredible city — the birthplace of jazz — but it also carries hard challenges, and for fifty years it has lived with more than 120 murders a year. We were there to tell the story of the people trying to change that math.

The model is built on a simple, startling insight: in 2018 the city's 474 shootings carried an aggregate cost of about $25.7 million, roughly 70% of it borne by Medicaid insurers. So the question became — what if managed care organizations invested on the front end to prevent shootings altogether, and shared in the savings? Our job was to make that idea, and the human stakes underneath it, land with a viewer who'd never heard of outcomes-based financing.

Production Challenge

The hard part of a film like this is that the subject is half policy and half people, and you can't shortchange either. Outcomes-based financing, Medicaid cost data, and capital-markets funding are abstract by nature — but behind every number is a person who got shot and a family deciding whether to stay in their neighborhood. We built the piece to move between the two: clear, credible voices explaining the innovation, grounded in the lived reality of a city working to keep its people alive. The tone had to be serious and hopeful at once, never sensational, so the work could stand up as both an explainer and a story.

About This Project
Client: Humana
Type: Documentary, Public Health Initiative
Location: New Orleans, LA
Services: Documentary video production, on-location interviews, cinematography, editing

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Video Transcript:

New Orleans is such an incredible city — the birthplace of jazz, our people second to none. However, we are also a city that's got incredible challenges. One of them is poverty. Another is violence. For the last 50 years in New Orleans, we've had over 120 murders every year.

Now, the Office of Gun Violence Prevention has three core parts. The first is to deliver public health, non-law-enforcement interventions to folks who are at risk. The second is to study those interventions through a partnership with Tulane that we're calling the policy lab. And third is to figure out how to fund those interventions at scale.

In 2018, there were 474 shootings in the city, and those shootings had an aggregate cost of about 25.7 million dollars. 70% of that 25.7 million is borne by Medicaid insurers. And so it created this incredible light bulb moment for us where we said, hey — if we're going to spend 25.7 million dollars every year, what if we can convince some of these managed care organizations to invest some on the front end, so we can actually prevent people from getting shot altogether and they can save the costs associated with their care?

I think the City of New Orleans has recognized that you need new and innovative tools to really break the cycle of violence at an individual and community level. And by bringing outcomes-based financing, I can tell you that we could not be more thrilled and proud to be partnering with such creative thinking around this issue, so that we can sustain these programs and they can be around for a long time to make the kind of generational impact that's needed in the city.

Whenever a shooting happens, we get an alert, and we then dispatch a member of our team who has social work credentials — either to the hospital to do a needs assessment of the victim and their families and then to try to provide them with services, or to the actual scene.

Part of the thinking in our outcomes-based financing model is that we want to try to address not just the needs of that individual but also the needs of their family. Maybe they actually need to be moved from a particular neighborhood they're in into another neighborhood. Maybe they need their utilities paid. Maybe what they need is the funding required to get into some certification in another state or in another parish, so that they can be successful at welding or working offshore. This isn't a one-size-fits-all approach. It's actually allowing us to tailor how the capital is spent based on the needs of the individual who's at risk, so that we can maximize what we care about most — which is keeping them alive, keeping them healthy, and allowing folks to be able to thrive.

Never in the country has there been a scenario where these vital public health interventions have been funded through capital markets. The goal here is to create a sustainable source of funding that can allow us not just to address gun violence, but all of these other social determinants of health.

Humana has been, along with the city, just an innovative and creative partner in helping us think about ways that we can really scale this program. We understand that the city has a certain capacity, but in order to really improve health outcomes and do this in a way that can really interrupt violence in the city, we need to understand how health plans will be able to play a role. So health plans can then come in and commit to purpose-driven partnerships that can look at specific health outcomes that they're interested in improving in the city. Investors then can come in and participate by driving capital to specific violence interruption and prevention programs that are tied to those measurable health outcomes. They can also see a monetary return and an improvement in social impact.

I mean, I think this is visionary. What's got me so excited is the fact that it takes an interdisciplinary approach to solve really tough problems. And this is the first time that something like this has happened to address gun violence not only in New Orleans, but nationally.