Friday, July 31, 2020

6 COVID-19 Social Determinants of Health Payers Pivoted to Meet


In light of rapidly changing times, payers are adapting old strategies to service new challenges in addressing certain social determinants of health.
July 02, 2020 - Payers are finding new ways to tackle social determinants of health as new challenges emerge, America’s Health Insurance Plans (AHIP) explained.
Much of the common knowledge that payers have built up around social determinants of health over the past few years continues to be relevant. However, they are also adapting their strategies for the new levels of uncertainty that coronavirus imposes.
“Health insurance providers, local healthcare and social service providers, communities, and other partners are rallying together to innovate and build new service delivery models to deliver critical resources to people experiencing greater socioeconomic needs during this time,” the AHIP brief stated.
There are six key areas in which payers have had to adapt their traditional social determinants of health strategies.
Virtual access to care, telehealth
Telehealth access has developed into a much more critical social determinant in recent history. Since the majority of nonurgent care needs have been transitioned to virtual and telehealth platforms, ensuring patient access to the necessary tools is crucial.
CareOregon tackled this problem in a straightforward way. The payer collaborated with its healthcare providers to offer flip phones and smart phones to patients who may not have one. This helped encourage patients to continue connecting with their providers even when they could not come into the office.
Food
Food insecurity has always been a major social determinant of health, affecting more than 19 percent of US adults, according to the CDC. However, as Americans face social isolation and children’s school lunch programs ended with the school year, addressing food insecurity is a growing priority for payers.
In response, Humana in Louisiana took its medical transportation vehicles and put them to a new use. Since food banks could no longer serve these communities, Humana drove food to vulnerable members.
Transportation
Although most people have  been largely constrained and made homebound by quarantine, members still will need to travel outside of their homes in order to receive coronavirus testing or treatment. Not all members have access to affordable and convenient travel options.
While in the past many payers have covered transportation to and from the care delivery site, Blue Cross Blue Shield of Oklahoma decided to tackle this barrier by bringing the care delivery site to its members instead. The payer collaborated with the local government in Oklahoma City and Tulsa to send out vans equipped for coronavirus testing into vulnerable communities.
Housing
Social isolation has visibly underscored the impact of housing social determinants. In coronavirus hotspots like Boston, Massachusetts, local governments and healthcare organizations established pop-up field hospitals to service homeless populations.
Some payers, such as Blue Cross Blue Shield of Massachusetts, got involved in these efforts by contributing staff.
Commonwealth Care Alliance (CCA)—which offers a special needs plan and a dual eligible plan—coordinated with local and state governments to transform hotels in Massachusetts into low-acuity quarantine and recovery spaces for housing insecure populations.
While patients were at the one of the six facilities, CCA also provided addiction services, helped patients find housing, and enrolled eligible patients into Medicaid upon discharge.
Employment
Employment levels have been plummeting under the weight of recession, often robbing workers of their employer-sponsored health plan coverage when they get laid off.
CareSource’s JobConnect worked to connect members with employment by offering educational and skills building programs. Members had the potential to be hired by one of CareSource’s more than 500 employer partners, most of whom continued to have open positions through the crisis.
Payers have also been changing their own hiring practices. When vulnerable communities are underrepresented in the payer workforce and partnerships, it enables a gap in care.
Horizon Blue Cross Blue Shield New Jersey’s Horizon Neighbors in Health program pursued member engagement through community-based organizations which understand a local population’s cultural makeup in order. These communityn health partners helped the payer disseminate coronavirus-related information to members.
Identifying at-risk populations for coronavirus
In order to successfully navigate population health management, payers need to acquire accurate population health data. The urgency for such data was even greater during the coronavirus pandemic as healthcare organizations scrambled to problem-solve for an unknown virus.
CareFirst developed a dashboard of population health data available for local governments and healthcare organizations to help identify and assess vulnerable populations. CareFirst started with the CDC’s Social Vulnerability Index and zip-code level social determinants of health data.
The payer then connected with over 180,000 members who the dashboard determined were at risk of contracting coronavirus and worked to gather data and offer support.

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