SHELBY LIVINGSTON June 21, 2019 04:28 PM
NASHVILLE, Tenn.—Five hundred Facebook friends
are no substitute for face-to-face interactions, but many people today are
swapping digital connections for tangible ones. That's partly why about a fifth
of Americans struggle with feeling lonely, former U.S. Surgeon General Dr.
Vivek Murthy said Thursday.
Speaking at the AHIP Institute & Expo in
Nashville, Tenn., Murthy explained that lonely people live shorter lives and
are more at risk for chronic illnesses like heart disease, depression, and
dementia. Moreover, public health crises like the opioid epidemic and gun
violence can trace roots back to loneliness and social disconnection, he said.
Tackling those crises will require healthcare companies to make fostering
relationships among patients with their communities a priority.
"For too long issues like social connection
have been looked at as soft subjects—the stuff that we'll get to if we can get
to it, after we get people the procedures and medications they need,"
Murthy said. "But putting it at the center of our concerns along with the
other major drivers of health is important culturally speaking."
Some health insurers and healthcare systems are
working to do just that by partnering with community organizations and employers
or even having staff phone patients regularly so they feel less alone. It's
part of a broader focus on the social determinants of health. Blue
Cross and Blue Shield of Minnesota providing grants to communities to improve
the social connectedness among their residents as those communities become more
demographically diverse, said Dr. Mark Steffen, Blue Cross' chief medical
officer.
A CareMore Health System program that treats loneliness
like any other chronic disease is now being rolled out to Anthem's Medicare
Advantage patients after initial results showed a 21% decrease in hospital
admissions over a 12-month period, said Robin Caruso, the system's chief
togetherness officer.
Under the program, CareMore's "togetherness
officers" call the loneliest patients regularly and connect them with
community resources for things like transportation or healthy meals. Those
officers have made about 24,000 calls in two years and made 1,800 referrals to
community resource and programs.
Cigna, meanwhile, has focused on raising
awareness of the loneliness epidemic through research and encouraging employers
to promote good relationships among workers.
A 2018 Cigna survey of 20,000 U.S. adults found
that about half felt lonely or left out; 40% reported having no interactions
with other people; and a quarter said they had no one to talk to. The survey
also revealed that 18- to 22-year-olds reported feeling the loneliest and also
reported feeling worse in health than older adults reported.
"That really told us we needed to step up
and figure out what we can do to address loneliness,"
Dr. Douglas Nemecek, the Bloomfield, Conn.-based
insurer's chief medical officer for behavioral health, said during an AHIP
panel Thursday.
Cigna is working with its employer health plan
clients to help them promote social connections in the workplace through
resources they may already have, like affinity groups, volunteer activities or
sports leagues. Cigna also has a program to keep caregivers who stay at home to
care for a family member from losing their social connections, Nemecek said.
Cigna's focus on loneliness is part of a broader
emphasis on integrating behavioral and physical health in its accountable care
organizations and other value-based care programs. The insurer is working to
create "medical neighborhoods" that bring together the primary care
physician with the behavioral health specialists to improve communication
between the two leading to more coordinated care, Eva Borden, Cigna's senior
managing director of behavioral and medical solutions, said during another
panel.
Dr. Cheryl Pegus, chief medical officer at Cambia Health Solutions, a Portland, Ore.-based company
that is the parent company of six health plans in four states, said Cambia
trained its customer service representatives in mental health first aid and
moved to care management model in which a single nurse coordinates all care for
a patient, bringing in behavioral health or other specialists when needed.
Cambia has also worked to address the opioid
addiction crisis by reducing opioid prescribing by physicians and intervening
at the point of sale at pharmacies. In January 2020, Cambia members will be
able to get overdose drug reversal drug naloxone for a $0 copay, Pegus said.
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