July 2, 2018
There’s more to good health than good genes and healthy habits. Health is influenced by many factors—or social determinants—defined by the conditions an environment where individuals are born. This includes housing, education, employment, and access to healthy food.
“I can educate my patients about the value of healthy eating and exercise,” wrote Dr. Patrick Conway, CEO of BlueCross BlueShield of North Carolina, “but if they don’t have transportation to a grocery store, or a safe neighborhood to walk in, then they can’t do what they need to improve their health.”
In a recent U.S. News op-ed, Ken Burdick, CEO of WellCare Health Plans, describes the health insurance provider’s work over the last seven years to connect members in need with access to social services including food, medication assistance, and transportation. They’ve found that providing this service has led to a 26 percent decrease in emergency spending.
“Data is the key,” says Gabriel Medley of Gateway Health. By collecting information from members about their social determinants of health, and running that up against claims and other data, they can get a more complete picture of members’ health, and opportunities for improvement.
People who live in underserved communities get caught in a cycle where lack of access—to food, transportation or providers—leads to poor outcomes.
We know that a healthy diet is key to good health. Yet one in eight Americans suffers from food insecurity—that is a lack of access to healthy foods due to transportation or socioeconomic issues. So, health insurance providers are finding new ways to help people access healthy food, whether by engaging grocery delivery services or providing rides to grocery stores, like this program from Health Alliance Plan of Michigan.
Looking again at Michigan, the Blue Cross Blue Shield of Michigan Foundation is working to support produce prescription programs in their state. Nationwide, initiatives provide vouchers or coupons to local farmers markets so that patients who may not otherwise be able to afford it can access fresh fruits and vegetables.
The food we eat also impacts our dental health, as do socioeconomic factors that influence access to dental care and coverage. In fact, “many of the determinants of dental health go way beyond medical factors—they are behavioral, cultural, social, and economic as well,” according to DentaQuest, one of the nation’s largest dental health providers.
And what if food is not easily accessible? Mutual of Omaha, for example, takes it a step further to partner with a local food bank to bring meals to children in need during the summer months, when they don’t have access to school meal programs.
Plans and service providers are also trying out services like Lyft and Uber to help patients get to their doctor or pharmacy. Closing the transportation gap can reduce the number of missed appointments and help make sure that patients are able to take their medication as directed.
Additionally, the emergence and incorporation of telehealth is another important, platform that ensures patients have access to care in real time – often without the need for any transportation. Consumers already love telehealth, citing the convenience of accessing care, and the lower cost of a virtual appointment when compared to an office visit. In fact, plans like BlueCross BlueShield of Tennessee have been using telemedicine to help bridge the transportation gap for women with high risk pregnancies in rural areas who may have trouble accessing specialists. Health plans find that they’re helping moms to have healthier babies and better outcomes, which in turn helps the health care system avoid costlier neonatal intensive care.
As we learn more about the tremendous impact of social determinants, more health insurance providers are developing programs to help their members access the tools they need to achieve their best health. And as people and plans see positive results in terms of health outcomes, we can look forward to deepening our understanding of the factors that influence health.