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Social determinants of health take center stage during the Covid-19 crisis

social determinants of health,

The Covid-19 pandemic is changing the way we think about care and total wellbeing support. At this time, progressive health plans would normally be trying to close gaps in clinical care, to avoid the year-end scramble that many others experience. But, with providers trying to keep patients out of the clinic and hospital, priorities have shifted elsewhere. In particular, many plans are taking a more holistic look at the wellbeing of their members in an effort to keep them healthy at home. Understanding how social determinants of health (SDOH) – lifestyle and environmental factors, such as job status, financial security and relationships – impact a person’s overall health can help health plans tailor their programs to address the evolving needs of their members in this rapidly evolving time. Particularly for health plans, this valuable information can help them target specific people who may be at higher risk of contracting Covid-19, or those who may be experiencing health issues related to social isolation, food insecurity or job losses, and to assist them with improving their total health and wellbeing by providing the appropriate communications with actions that could keep them safe.

Consumers fear the uncertain future, and traditional models of communicating with members are not feasible in the current environment. It’s essential that health plans think critically about how the lives of their members are changing during the current pandemic – beyond just their clinical needs – and reframe their services and their communications accordingly.

With traditional models of care in flux during this time of “shelter in place,” how health plans communicate with their members is more important now than ever. For example, regulations are being relaxed to allow more patients to use telehealth services; however, many people may not be aware of telehealth resources available to them. For seniors managing chronic conditions, leveraging these services could mean the difference between staying healthy and ending up in the hospital due to complications from Covid-19 or other conditions. Having insight into SDOH data for their older adult members can help health plans better understand if telehealth might be useful for those members and communicate the potential benefits to them. Do they have access to a computer or smartphone? If not, do they live with a spouse, adult child or another caregiver who can offer that support? Tailoring programs and communications based on members’ personal situations and current and future needs can help ensure they understand and take action to use these services.

One-size-fits-all messages won’t work. For some people, staying home is not an option if they work in an essential industry, so bombarding them with messages about self-quarantining is irrelevant and results in wasted effort. Or, if someone loses their job, a lack of income could put them at risk for food insecurity or homelessness; the first order of business should be to address those factors before sending a generic reminder to fill their prescriptions. Personalized and empathetic communications are essential. If you keep telling someone to do something but they aren’t in a position to do it, the messages will fall on deaf ears and eventually just be ignored. Members may then tune out future communications, with potentially important actions and reminders.

Planning for future needs
During the Covid-19 pandemic, many health plans have stepped up their offerings to members and found ways to help ensure continuity in clinical care. For example, several plans have waived co-pays and fees for Covid-19 testing. However, a large gap remains in how health plans address factors in members’ everyday lives which can have a significant impact on their overall health.

This is a time of unprecedented stress. Many people have concerns about job loss, access to food, social isolation, housing insecurity and other factors that can directly influence their personal wellbeing. It’s essential that they have access to information and resources around services such as mental healthcare, coaching and telemedicine, which can influence their social determinants of health.

While health plans need to be thinking of the implications of today, they must also consider how their members’ needs may evolve in the future. People who are living alone and isolated from family and friends may experience depression for the first time. At-home workers who are sitting at the kitchen table in front of a computer for eight hours straight may face long-term back pain. Those who have been laid off and are experiencing financial insecurity may have to make gut-wrenching decisions between whether to pay for medication or food. This is a whole new world and it’s important for health plans to think of not just the current situation, but what could happen in 60 days, 90 days and next year.

Health plans are in a unique position to provide support beyond clinical care to get ahead of many of these potential issues. Having access to timely, relevant data about current and evolving SDOH factors is key to both better understanding how environmental and lifestyle changes can impact a person’s health status and putting plans and communications in place to help improve outcomes and prevent future problems.

Keeping up to date on changing member needs
Understanding how member needs are changing is equally important to tailoring the appropriate messages. If a health plan’s resources can’t be utilized because of a change in lifestyle or situation, they need to evolve to remain relevant and effective. Staying in touch with members through regular, tailored communications will enable plans to support their members’ total wellbeing during the Covid-19 pandemic and beyond.

One example is sharing up-to-date information on Covid-19 with members as it is available, including guidance on who should undergo testing and where to go for treatment. This information may change depending on where members live. Recommending people get tested for Covid-19 at a clinic may not be feasible for a member living in a rural area where testing is limited. In that instance, the first step may be scheduling a telehealth appointment with their provider to assess if they should schedule an in-person visit.

Another way health plans are keeping up with changing member needs in the time of Covid-19 is by developing innovative wellbeing offerings for homebound members. With many people in communities under “stay at home” orders, this is an opportune time to offer resources like online fitness and nutrition programs as well as condition management programs. By being the trusted source of information and providing personalized and consistent support, people will listen and turn to trusted health plans for support.

This is a time of unprecedented and scary change for so many people. Health plans have a clear opportunity to make a meaningful impact in the lives of some of our most vulnerable populations by fostering greater connection with their members and adjusting their programs to meet their current and future needs. Understanding the social determinants of health for their members is key to offering programs and resources with the highest potential for having a positive impact on wellbeing.

Photo: vaeenma, Getty Images

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