Humana’s Bold Goal strategy led to a 6.8 percent decrease in the number of unhealthy days for San Antonio members. A previous version listed 8.6 percent as the figure. Humana has partnered with a technology platform and a group of community-based organizations to address social determinants of health for Medicare Advantage members in San Antonio, Texas. Alamo…
The long-term care industry is facing an employment crisis, and providers must go beyond traditional compensation and benefit offerings to solve them. This industry’s employee demographic operates with unique characteristics that influence their needs and desires from an employer. Employers must consider their employees’ social determinants of health in order to build a customized incentive,…
Congresswoman Cheri Bustos (IL-17) is hopeful about the Social Determinants Accelerator Act, a bill she’s cosponsored to help get funding directly to communities for the purpose of addressing social determinants of health. The bipartisan bill, among other proposed legislation, got airtime late last week during a hearing of the House Committee on Energy & Commerce….
Social determinants of health have been linked with metabolic diseases and other conditions, and researchers have found that improvements in these areas can have an equal effect on disease risks, according to a presentation at the American Diabetes Association’s 81st Scientific Sessions. Countries’ social and economic development is highly correlated with a healthy life expectancy…
The transition from traditional fee-for-service (FFS) payments to valuebased reimbursement models is fundamental to the future of healthcare. Rather than rely on the number of tests or procedures to inform financial reimbursement, value-based care (VBC) models incentivize providers to deliver on three components: improving the patient care experience, improving the health of populations, and reducing…
Social isolation, a key social determinant of health (SDOH) can have a negative effect on mental and physical health outcomes. Individuals in long-term care (LTC) facilities have higher 30-day mortality rates when the facility is in a socially isolated location, according to a study from the Journal of American Medical Association (JAMA). Since the coronavirus…
Value-based care (VBC) is a crucial step towards improving access, equity, and quality healthcare for Americans. Since the inception of Blue Cross Blue Shield in the 1930s, the US healthcare system has relied primarily on fee-for-service (FFS) payment practices. Essentially, you go to the doctor for a specific need, the doctor serves that specific need,…
Machine learning is getting better at predicting things. There are now algorithms that improve the detection of diabetic retinopathy, predict the onset of sepsis, and help determine a critically ill patient’s risk of dying. But a piece of wisdom from Warren Buffet comes to mind: “Predicting rain doesn’t matter. Building arks does.” Even the most…
The current pandemic will likely have significant negative long-term consequences on health, with the economic downturn, job losses, social and emotional effects of social distancing and sheltering, and disruption to routine health care and education. These pressures exacerbate the existing shortfall of investment in social determinants of health (SDOH). Looking ahead, finding mechanisms to unleash…
There is increased recognition for better methods to measure, predict and adjust for social risk factors in healthcare and population health. Current performance and quality measures generally do not take SRFs into account in the bonus/penalty structure, nor are SRFs generally included in most risk adjustment formulas. This can lead to unintended consequences, including the…