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Is Overcoming Social Determinants of Health on Your Radar?


Blue Cross and Blue Shield’s new alliance with ride-sharing company Lyft spotlights the vital need to help healthcare consumers overcome their many obstacles to care, from low health literacy, language barriers and limited mobility, to housing instability, food insecurity and insufficient transportation.

The collaboration, which is intended to “mitigate the powerful effects of social determinants of health,” provides select Blue Cross and Blue Shield health plan members facing transportation barriers with free rides to non-emergency medical appointments. The goal is to improve healthcare access and reduce the number of missed appointments due to transportation challenges, ultimately improving health outcomes.

Social Determinants of Health
According to the Office of Disease Prevention and Health Promotion, social determinants of health are “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”

Income level, employment status, community environment, education level, support networks, food supply, and the many other social determinants of health can have a substantial impact on the well-being of individuals and families, as well as their ability to access the care needed to improve it.

Holistic Approach Critical
To successfully deliver value-based care, improve individual and population health, and reduce healthcare costs, it’s critical for policymakers, payers and providers to address the many social, economic and environmental factors that influence well-being.

“A holistic assessment of individuals, families and communities is necessary to develop a comprehensive profile of their needs, more accurately identify their risks, and create integrated solutions that connect healthcare with social support services,” says Jennie Echols, PhD, MSN, RN, Director of Clinical Solution Development at Carenet Healthcare Services.

Data Collection and Intervention Challenges
“While most people agree on the importance of addressing social determinants of health, how to intelligently and efficiently collect the relevant data and implement interventions on the individual and population level remains a difficult challenge,” says Echols.

Many organizations are weaving social determinant data into analytics to more accurately predict the needs of populations and target individuals for outreach and engagement.

Other healthcare delivery systems are organizing agencies to deliver integrated services; analyzing outcomes; and continually improving management and delivery processes to generate better outcomes while controlling expenditures across programs.

“For maximum effectiveness, healthcare organizations must take into account not only a person’s health data, but also the individual’s contributing cultural, environmental and economic factors, as well as his or her family dynamic, social supports and community resources,” says Echols. “Only then can resources be put into place — at the individual, family and group level — to achieve optimal health outcomes across the diverse spectrum of individuals and the population.”

Carenet Can Help
Carenet can help healthcare organizations collect social determinants of health data and put the valuable insights captured into action via personalized interventions.

By utilizing proactive outreach measures and proven consumer influence, engagement and advocacy strategies, we can create a 360-degree view of individuals and families that enables identification of people facing social determinants of health that are negatively impacting their well-being and access to care.

Once issues are pinpointed, we can help healthcare consumers overcome their barriers whether it’s enrolling them in a disease management or tobacco cessation program; providing education on health topics and treatment options; or connecting them with a virtual telehealth provider or local support services such as food banks, transportation providers, housing assistance, free job training courses and subsidized child care.

As a result, we will improve care access and delivery, resource utilization, readmission rates, clinical and financial outcomes, and more. To learn more, click here to contact Carenet today to schedule a discovery session.