CAHP Seminar: Social Determinants of Health

The California Association of Health Plans (CAHP) hosted a seminar last week in Burbank, focused on the Social Determinants of Health (SDOH). The event featured presentations and panel discussions by industry leaders about the evolving perspectives on the social determinants of health, opportunities to drive value-based care, and partnering with community-based organizations. CAHP defined SDOH as a term intended to capture all the environmental factors that impact a person’s health.

After the CHRONIC Care Act was signed into law in 2018, Medicare Advantage (MA) plans gained the authority to cover non-medical benefits, including home modifications, food delivery, and transportation. In addition to similar programs provided by payers, there were over 20 million MA enrollees this year. Since MA enrollment has nearly doubled in the last decade, the need to understand, structure and implement these new benefit designs is rapidly growing for plans expanding their offerings.

As we learned at the CAHP seminar, many plans are using 2019 as a year to test different benefit offerings. This was illustrated in detail by Jennifer Kowalski, Vice President, Public Policy Institute, Anthem, during her presentation on Wednesday. This year, Anthem has expanded a wide range of benefit offerings, from personal assistants in the home to alternative pain treatment. Ms. Kowalski spoke about the positive effects of strategies in combatting social isolation with aging Medicare Advantage members. These benefits can take many forms, from Anthem associates volunteering as phone pals and calling their buddy for weekly chats to increasing the number of round trips offered, so this population can request rides to the gym or social activities outside of their doctor appointments.

One of the morning’s first speakers, Chris Esguerra of Blue Shield of California Promise Health Plan, set the tone for thinking beyond the four walls of a clinic or hospital. As Senior Medical Director, Mr. Esguerra spoke about how his team is focusing on holistic care and thinking about all of the different things that can affect every member’s life. He asked, how do we start to integrate social needs into healthcare? Mr. Esguerra explained, “social determinants as a phrase can be valueless, yet when those determinants of health lead to a social need, that’s where the opportunity is. How do we support that member and look at their circumstances holistically? We have to look at the individual, their families, and their communities.”

With our technology and best-in-class network, transportation is a scalable benefit that leads to happier, healthier members. ALC offers healthcare plans and facilities an unparalleled partnership. Whether your organization is looking to augment or add transportation benefits, we can help. Our trustworthy team has over twenty years of experience in the transportation industry and can provide guidance in designing workflow and the CMS submission process. Connect with our knowledgeable team for a complimentary analysis and discover your opportunities to maximize value for your plan.

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