Monday, September 30, 2019

Why Medicare Is Focused On Food Insecurity


Bruce Japsen Senior Contributor Sep 30, 2019, 11:00am
The inability of seniors enrolled in Medicare to get the food they need is a problem for nearly one in 10 enrollees 65 years of age and older, a new analysis shows.
The issue of food insecurity has emerged as a healthcare concern and is now on the radar of health insurance companies, Medicare and Medicaid administrators as a way to get seniors better care.
Research published Monday in JAMA Internal Medicine shows “nearly 1 in 10 Medicare enrollees age 65 and over and 4 in 10 enrollees younger than 65 with long-term disabilities experience food insecurity,” the inability to get adequate food for financial reasons.
“These findings highlight the appropriateness of the Centers for Medicare & Medicaid Services intensifying focus on social determinants of health, exemplified by the accountable heath communities model, which targets dual enrollees, and the recent expansion of allowable supplemental benefits in Medicare Advantage plans,” Jeanne Madden a professor of pharmacy at Northeastern University in Boston and her colleagues wrote in the research letter published Monday in JAMA Internal Medicine.
The Centers for Medicare and Medicine Services has changed rules to allow private Advantage plans that contract with the government to provide health benefits to seniors to cover more supplemental benefits. It’s a key reason why seniors are flocking to Advantage plans sold by CVS Health unit Aetna, UnitedHealth Group, Humana, Cigna and array of Blue Cross and Blue Shield plans and startups that are beginning to offer more supplemental health benefits like food delivery, access to ride-share transportation and other new ways to make sure patients are getting screened and getting care in the right place and at the right time.
The study indicates there’s an opportunity for Medicare and private Advantage plans to help seniors get better care upfront and avoid a more serious and costly illness in the future.
“Food insecurity screening and referral programs in clinical settings may benefit from recognition of high-risk patient groups,” Madden and her colleagues write in JAMA Internal Medicine. “Auto enrollment and smoother recertification of low-income individuals could help make public efforts like the Supplemental Nutrition Assistance Program and home-delivered meals even more effective. All health system innovations, including direct food provision (eg, through medically tailored meals, outpatient food pharmacies, and care packages at hospital discharge),1 require rigorous evaluations before broader implementation.”
For the study, researchers examined 2016 data from a survey of more than 9,000 Medicare beneficiaries analyzed for risk “factors found that lower incomes, reporting four or more chronic condition diagnoses, and having symptoms of depression or anxiety were each independently associated with food insecurity in both age groups.”
Health insurance companies say they are intensifying their efforts to screen for social determinants of health, including food insecurity.
At Humana, for example, the health insurer launched several years ago a “Bold Goal” initiative addressing food insecurity and social isolation as primary areas of need for certain seniors enrolled in its Medicare plans.
“Food insecurity is a leading barrier to achieving good health among all populations, particularly with seniors,” Humana’s Chief Medical and Corporate Affairs Officer Dr. Will Shrank said. “We have seen firsthand that seniors who suffer from food insecurity have had to forgo their daily medicines so they can eat, which can then negatively affect their ability to manage diabetes. It is clear that seniors’ basic needs are not being met, compounding the challenges of managing their complex medical problems.”

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