Seniors’ Unmet Social Needs Drive Greater Acute Care Utilization

Featured Infographic   Seniors’ Unmet Social Needs Drive Greater Acute Care Utilization   Health-related social needs (HRSNs) can increase acute care utilization among Medicare Advantage members — including avoidable hospital stays and emergency department (ED) visits — asserts a July 8 investigation published in the Journal of the American Medical Association’s Health Forum. Researchers studied a group of about 56,000 older adults enrolled in MA plans offered by Humana Inc., and found that HRSNs, such as housing, utility and food insecurity, limited access to transportation, and financial difficulties, were associated with significantly higher acute care usage. Just under half (49.3%) of the study population reported experiencing at least one HRSN. Beneficiaries experiencing one or more HRSNs had a 53.3% higher rate of avoidable hospitalization than those without HRSNs. Unreliable transportation was the HRSN with the largest association with hospital stays and ED visits, both avoidable and unavoidable, while financial strain was associated with the most avoidable hospital stays. Loneliness, meanwhile, had the most significant association with avoidable ED visits, yet its effect on hospital stays was far less consequential.

NOTES: Some of the study authors were affiliated with, reported equity holdings with, or were previously employed by Humana Inc., but the insurer did not sponsor the report. Data on hospital stays represented an aggregate of inpatient admissions and observation stays. Avoidable hospital stays were defined using the Agency for Healthcare Research and Quality Prevention Quality Indicators. Avoidable ED visits were defined using the New York University ED visit algorithm. SOURCE: “Association Between Self-Reported Health-Related Social Needs and Acute Care Utilization Among Older Adults Enrolled in Medicare Advantage,” JAMA Health Forum, July 8, 2022.   From Radar on Medicare Advantage Learn more about subscribing to AIS Health's publications.