The uncertainty and risk created by pandemic-related disruptions in care have health plans in uncharted water when it comes to relying on claims data and utilization patterns to inform their risk models. But while these disruptions weakened the reliability of traditional risk models, they also created opportunities to deepen and enrich member data by leveraging…
The fast-spreading Delta variant is the dominant strain of a virus many had hoped would be eradicated by now. COVID-19’s Delta variant was first identified in India in December of 2020. Now Delta accounts for 97 percent of new infections in the United States, according to data from the Centers for Disease Control (CDC). The growing impact of Delta…
For South Texas Physician’s Alliance, social determinants of health referral has been a learning experience. The organization, which has joined providers across the country in efforts to address social determinants of health, knew the best solution was connecting patients to social services providers. A patient presenting with food insecurity needs a referral to a food…
Is it possible for disparities between population cohorts to be overcome or neutralized through technology? I believe the answer is yes. Over the past year, COVID-19 has magnified the gaps in healthcare on a large scale. We see this in higher rates of the virus in people of color, through the access or lack thereof…
Value-based care is now firmly entrenched in our healthcare system. Payers credit value-based care with lowering costs, improved outcomes, enhanced payer/provider relationships, and improved patient engagement. With the growth of value-based care models, a trend gaining traction is the transition from treatment at a provider’s site to a patient’s home. This shift to home and…
The number of Medicare Advantage plans investing in supplemental benefits to address social determinants of health tripled in a single year, but additional guidance and standards from the Biden administration are needed, a new report said. The report, released Thursday by the Better Medicare Alliance, comes as the Biden administration has made it a priority…
Extensive research and the pandemic have elevated the importance of addressing social determinants of health (SDOH) to improve health and reduce longstanding disparities in health and health care.1 Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Prior…
As Medicare Advantage continues to serve a proportionally higher-risk and more diverse enrollment population, a new report highlights innovative approaches to addressing social determinants of health (SDOH) for Medicare Advantage beneficiaries, while acknowledging barriers that remain. Social determinants of health are non-medical factors that account for up to 55% of an individual’s health outcomes, according…
In recent years, Medicare Advantage (MA) plans have increasingly turned their attention to addressing members’ social determinants of health (SDoH), with the home playing a crucial role. That’s according to a new report from NORC at the University of Chicago. NORC conducted the report on behalf of Better Medicare Alliance’s (BMA) Center for Innovation in…
In conversation with NEJM Catalyst’s Executive Editor, the Director of the Johns Hopkins Center for Health Equity and Johns Hopkins Urban Health Institute defines health equity, equitable access, and equitable quality of care, describes how antiracism strategies at both the structural and personal level support these concepts and will improve care for all patients, and…