There’s no denying that social determinants of health (SDoH) are impacting consumers directly. Case in point: This recent feedback from a call center member about an Icario rewards and engagement program:
“I really appreciate this [gift card] very much. We are poor, we are about ready to take off the cable, and food prices went up. Things are bad. This helps us… I had an MRI done this month, a stress test, a brain scan, and a scooter evaluation… I’ve been busy this month.”
With the financial incentive offered through our program, this member was encouraged to get the healthcare she needed, despite the barriers. Just a small reward to help with daily expenses was enough to get her to the doctor, get her risk identified and help her engage with the healthcare system.
Hers is a powerful statement because it illustrates the kind of choices some consumers are faced with every day: Can I afford food, medicine, and my healthcare visits?
And it’s just one instance of how SDoH can affect health outcomes in concrete ways. After all, first-rate healthcare means very little if members don’t have access to it—whether the barrier is a lack of transportation, housing or financial resources.
In fact, we now know that healthcare itself only accounts for 10% of health outcomes.
In addition, according to the CDC, “Addressing social determinants of health is a primary approach to achieving health equity. Health equity is ‘when everyone has the opportunity’ to ‘attain their full health potential’ and no one is ‘disadvantaged from achieving this potential because of their social position or other socially determined circumstance.’”
So, we know that addressing SDoH is important—but how can plans effectively influence those factors—and where should they start? Now that CMS has expanded MA supplemental benefits to cover items addressing SDoH—including transportation and food-delivery services—there’s never been a better time for plans to start.
We’ve identified three key strategies every plan should implement to reduce social barriers, engage hard-to-reach members, and truly impact health outcomes.
1—Use Data to Understand Your Members
To effectively engage members dealing with SDoH—who are frequently hard to reach—it’s essential to understand where they’re coming from, why they struggle, and how to best serve them.
Of course, it’s different for every population, but members facing SDoH frequently struggle with issues like transportation, economic stability, access to quality food, pollution and other environmental factors, and low health literacy, among others.
To accurately understand your population—and create an engagement program to connect them with the health and social services they may need—you’ll need to collect and analyze population data, factoring in social determinants, healthcare utilization, consumer behavior, and member interaction. With this data as your foundation, you’ll start out with a solid understanding of how to serve your members best.
2—Forge New Partnerships & Align Your Resources
It may benefit your plan to partner with local and national social service organizations to address SDoH. Aligning with these organizations cannot only extend your reach in the community, but it can also provide you with a direct channel to addressing social barriers to care. Use your data to guide which partnerships you choose—based on what services your members could most benefit from.
Internal alliances are equally important. Inside your plan, quality and care delivery executives can align teams to address SDoH collaboratively. Administrators can also set aside time for a designated team of social workers, healthcare providers and behavioral specialists to work together to tackle SDoH issues through a member rewards and engagement program.
And there’s good news to fuel these alliances: Establishing an engagement program doesn’t have to mean diverting resources from care—these programs can be covered by a plan’s quality budget.
3—Develop the Right Member Communications & Incentives
When it comes to SDoH, the health plan’s role is really to improve awareness and provide assistance connecting members with the health and social services available to them. Leverage your partnerships to get the word out and engage with members. And choose communication channels that are preferred by and accessible to your population. This may mean mobile (50% of smartphone users have an annual household income of less than $30,000), provider outreach, worksite outreach, storefronts, community partnerships, etc.
We also highly recommend using financial incentives to motivate patients to connect with care providers and complete “high-value activities”—those that have the greatest value to your members and plan alike. This may include preventive care like cancer screenings, pre- and post-natal care, disease management, and other recommended care appointments.
But don’t offer just any incentive—choose the right one. For example, consider strollers for prenatal program participation, or grocery store gift cards for members who, like the example above, may struggle to pay grocery bills. When you can offer members something they will truly value, they are far more likely to engage.
Lastly, don’t forget to offer financial resources—such as shopping tools or co-pay assistance—to help members remain adherent to medication and care plans. Sometimes even seemingly small amounts of monetary assistance can dramatically increase a member’s likelihood of continuing on with their care.
