The integrated health plan has a strategy to combat the effects of isolation and its effects, which increase the risk of Alzheimer's disease, obesity, and hospital readmissions.
CareMore, the Anthem subsidiary that operates integrated Medicare Advantage plans in 7 states, this week announced it would take on a condition that increases the risk of Alzheimer’s disease, stroke, obesity, and premature death in America’s seniors. That condition is loneliness.
Sachin Jain, MD, MBA, FACP, CareMore’s CEO, said doctors often don’t ask about loneliness because they don’t have ways to help. But signs of loneliness are all around medicine—often, a doctor’s appointment is the most social interaction an older person experiences. When this occurs, people stop caring for themselves and stop taking medications. Other research supports Jain’s cause—a study at the University of North Carolina in 2016 found that the size of a person’s network of friends directly correlated with his or her health, in adolescence and late in life.
Called “Be in the Circle: Be Connected,” the CareMore plan seeks to reframe loneliness as a treatable condition. By developing interventions to combat it, Jain says physicians can reduce its effects, as well as its costs to the health system. Here are 5 elements of the CareMore strategy to fight loneliness:
1. The loneliness crisis is significant
CareMore says that loneliness affects 43% of all adults over age 65 and is a risk factor in the progression of cognitive decline, recurrent stroke, weight gain, and premature mortality. Research shows that the lack of social connections can be as damaging to health as smoking 15 cigarettes a day. A survey by CareMore found that 1 in 5 seniors feel isolated from friends and family—a growing problem as families are smaller, and parents and adult children are more likely to live long distances from one another.
2. Use gyms, existing medical facilities
The CareMore system has gyms for seniors at most of its care centers, along with programs focused on creating social connections. Encouraging any amount of exercise is a good idea, especially if it’s with fellow seniors. CareMore is also redesigning the waiting areas of its care centers—so seniors don’t have to make a medical appointment as an excuse to show up and socialize. But if they do, they can get their blood sugar and weight checked.
3. A “Chief Togetherness Officer”
Longtime CareMore social worker Robin Caruso, LCSW, is the first person in healthcare with this title, and it’s her job to get the 700 clinical staff excited and accountable for the cause. Physicians will be expected to assess, look for, and treat loneliness—and CareMore will track how the program affects health outcomes, readmissions, and other quality indicators.
4. Reaching the homebound
Some seniors won’t come to a gym or care center, and CareMore has plans for them, too. The health system will have 3 outreach workers led by a social worker who will connect with homebound seniors regularly by phone to make sure they have enough support. Jain says the next step will be a “friendly visitor” program, through which seniors will get a home visit.
5. Make it replicable
Jain wants the loneliness initiative to move beyond CareMore. His goal is to create a social movement that treats loneliness as a medical issue so that it’s treated and not ignored. Such a movement would end the stigma associated with being lonely, and encourage medicine to treat patients “in the context of their lives,” a topic Jain addressed recently at the spring meeting of the ACO & Emerging Healthcare Delivery Coalition®.