Currently Viewing:
The American Journal of Accountable Care December 2019
Currently Reading
How Health Insurance Providers Are Tackling Social Barriers to Health
Kate Berry, MA
Delivering Holistic, Value-Based Care: Dr William Shrank Outlines 5 Issues
Laura Joszt, MA
Trends in the Use of Clinical Decision Support by Health System–Affiliated Ambulatory Clinics in the United States, 2014-2016
Robert S. Rudin, PhD; Shira H. Fischer, MD, PhD; Yunfeng Shi, PhD; Paul Shekelle, MD; Alejandro Amill-Rosario, MPH; M. Susan Ridgely, JD; Dennis P. Scanlon, PhD; and Cheryl L. Damberg, PhD
Comparison of Healthcare Delivery Systems in Low- and High-Income Communities
Christina A. Nguyen, AB; Michael E. Chernew, PhD; Isabel Ostrer, AB; and Nancy D. Beaulieu, PhD

How Health Insurance Providers Are Tackling Social Barriers to Health

Kate Berry, MA
When people are healthier, care is more affordable for everyone. For the healthcare industry, it is a common-sense decision to confront nonmedical factors that affect people’s health so dramatically.
The American Journal of Accountable Care. 2019;7(4):19-21
As much as 80% of a person’s health is linked to factors other than medical care, such as where one lives, grows up, works, and ages. However, many Americans have significant unmet social needs that affect care quality, health status, and use of care services. For instance, access to healthy foods is central to good health, but 35% of respondents in a recent study stated that they experienced food insecurity and were more than twice as likely to have multiple emergency department visits.1

Investing in prevention is key to healthier people, healthier communities, and lower healthcare costs. Knowing this, health insurance providers and other healthcare professionals are increasingly investing in innovative solutions that address social barriers to health and wellness, also referred to as social determinants of health (SDOH). Although clinicians, health insurance providers, and hospital executives are well versed in studying the impact of medical care like drug dosages, clinical settings, and treatment options on patients’ outcomes, emerging SDOH factors require different kinds of research and different kinds of programs to tackle social issues.

Social Barriers to Healthcare

When people are healthier, care is more affordable for everyone. For the healthcare industry, it is a common-sense decision to confront nonmedical factors that affect people’s health so dramatically. These factors include the proximity between a person and fresh produce or other healthy foods, how easily a person is able to access transportation to medical appointments, whether the person is living in safe and high-quality housing, if the person is living alone or has a social support system in place, and the underlying financial well-being of people and their families and how that affects how they pay for healthcare services.

Research has shown that these SDOH factors have a huge impact on people’s health outcomes. Some have estimated that medical care alone (eg, doctor’s visits, medications, treatment plans) addresses only about 20% of health outcomes.

Health Insurance Providers Are Tackling Social Barriers

Whole-person care requires more than just medical treatment. That’s why health insurance providers are coupling medical care with social approaches to foster an environment that supports the patient’s health goals (Box 1).

For instance, to support a patient who has received a diagnosis of type 2 diabetes, an insurance provider may go beyond medications and follow-up appointments to help the patient improve their overall lifestyle. The insurance provider may connect the patient with a dietitian or nutritionist to better support healthy eating habits, or it may work with a local food pantry or grocery store to establish a discount program to improve access to healthy fruits and vegetables.2 For patients who live in areas with limited access to fresh produce, health insurance providers are partnering with mobile food pantries3 and food delivery services4 to make it easier for patients to connect with healthy foods.

Health insurance providers are contributing to vital research efforts to advance the national dialogue on effective SDOH interventions. For example, in recent years, social isolation and loneliness have become recognized as factors that play a critical role in health outcomes. To better understand their effect, in 2018, Cigna released a study highlighting the results of a survey of more than 20,000 US adults that revealed that although nearly half of all Americans often feel alone, younger people are particularly at risk. Generation Z (including adults aged 18-22 years) is the loneliest generation, with the highest loneliness scores. The survey was the basis for a peer-reviewed original research article in the American Journal of Health Promotion.5 The article examines the survey data to better understand what individual factors are most strongly related to loneliness and provides actionable insights that programs can use to improve social connectivity.


 
Copyright AJMC 2006-2020 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up