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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