Is There More to Good Health than Good Genes?

Several years ago health insurance companies began to recognize good health is more than good genes. In fact, good health is fairly complex which is influenced by a number of factors including education, employment, housing and access to healthy food. Some social deterrents such as a person’s environment where individuals are born contribute to these issues. The simple fact is that some people simply do not have access or transportation to buy healthy food or a location where they can safety walk.

Nationally, health care systems are researching options to reduce health care costs. In a recent U.S. News op-ed, Ken Burdick, CEO of WellCare Health Plans, described the health insurance provider’s work over the last seven years to connect members in need with access to social services including food, medication assistance, and transportation. They’ve found that providing this service has led to a 26 percent decrease in emergency spending.

“Data is the key,” says Gabriel Medley of Gateway Health. By collecting information from members about their social determinants of health, and running that up against claims and other data, they can get a more complete picture of members’ health, and opportunities for improvement. People who live in underserved communities get caught in a cycle where lack of access to food, transportation or providers which leads to poor outcomes.

Good Food - We know that a healthy diet is important to good health. Yet one in eight Americans suffer from a lack of access to healthy foods due to transportation or socioeconomic issues. So, health insurance companies, like a program from Health Alliance Plan of Michigan, are finding new ways to help people access healthy food, whether by engaging grocery delivery services or providing rides to grocery stores. Many grocery stores have also identified this need and are providing a delivery service at a minimal fee.
And what if food is not easily accessible? In certain locations in the country, insurance companies are taking a step further to partner with a local food bank to bring meals to children in need during the summer months, when they don’t have access to school meal programs.

Providing access to care - For several years several Medicare Plan insurers have offered a transportation benefit to help people get to and from the doctor. Now several plans and service providers are also trying out services like Uber and Lyft to help patients get to their doctor or pharmacy. The goal is to close the transportation gap and can reduce the number of missed appointments
Additionally, the emergence and incorporation of telehealth is another important, platform that ensures patients have access to care in real time – often without the need for any transportation. Consumers like telehealth, citing the convenience of accessing care, and the lower cost of a virtual appointment when compared to an office visit. Telehealth has worked well from conditions from the common cold to high risk, high cost conditions such as high risk pregnancy to chronic conditions like COPD and heart failure.

So, the good news is that health plans and systems have recognized the outcomes of improved health and saving money (26% decrease in emergency spending) by including several wellness/preventative benefits. The net result for you can be better health and possibly decreased medical costs, including insurance premium costs. Although benefit information is not yet available for 2019 Medicare Plans, look for more of these services to be included in Medicare Advantage Plans. Keep your eyes open for these quickly moving changes.
2019 benefit information will be available after 10/1/2018. Feel free to contact our office for further information.

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