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Addressing Social Determinants of Health to Drive Member Retention, Outcomes
January 31, 2017

Addressing Social Determinants of Health to Drive Member Retention, Outcomes

Lisa DiSalvo is senior vice president of product strategy and development at Altegra Health, a Change Healthcare company.
  • Create a community program strategy. Housing and job assistance are often the most significant resource needs, yet they’re often the most daunting to address. To avoid getting “stuck,” build a bank of community resources for the next “tier” of common needs, including food, utilities, transportation, medication assistance and telephonic communication.
  • Implement a sophisticated program and member tracking tool. Programs and their supporting requirements change often. Using a software tool for program maintenance assures varying roles within the organization have access to the same program details. Find a software tool to effectively track member programs, including application processing, and plan to integrate that data into care management systems. Most importantly, be sure to partner with a software vendor capable of effectively maintaining and enhancing your program database.
  • Integrate a screening tool with community program and member tracking tool. Expand care management screening to include and score members based on social needs. Because members’ needs are often unique, adopting a technology solution capable of stratifying, standardizing and facilitating support will help programs be more effective and efficient. For instance, a tool that matches members with appropriate resources or services can have a tremendous impact, not only by meeting member needs, but also by streamlining the process to optimize the efforts of care managers and social workers.
  • Partner with provider groups. Engage provider relations to identify those struggling to address their patient’s social needs. Consider extending the aforementioned screening and community program software tools and encourage collaboration by exchanging information related to member needs and programs accessed.
  • Enhance member communication. Whether using live or automated calls, text messages and/or a combination of various methods, programs should not only increase benefit awareness, but provide direction on proactively seeking assistance when they need it. A plan should make available services known and have a visible presence in its community. Doing so will keep members engaged by meeting them where they are and building trust—something many individuals typically lack when it comes to their healthcare plans.
  • Actively participate in the creation of health policy. Together, healthcare entities can influence health policy that creates meaningful incentives to unify interventions for social determinants with clinical care. Whether Medicare, Medicaid, or private accountable care organizations, effective change can produce long-term cost reductions and improvements in care that benefit the entire industry.

Producing Favorable Outcomes

By leveraging technology to identify, stratify and facilitate programs that address not only the medical but also the social needs of its members, managed care plans can serve as an invaluable resource. After all, what’s more meaningful than preserving member retention and loyalty while reducing costs and producing better overall health outcomes?

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