Likely 25% of your members have type 2 diabetes, and many of them are struggling with social drivers that contribute to poorer health and increased hospital readmissions and trips to the emergency department. Healthy food can be expensive, and in some areas, hard to find. Many communities don’t have walkable areas or public transportation. Individuals who are living paycheck-to-paycheck can’t afford the extra expenses associated with visiting a specialist. But how significantly are SDoH barriers actually affecting your diabetic members?
The National Committee of Quality Assurance (NCQA), state Medicaid agencies, and the Centers for Medicare & Medicaid Services (CMS) have emphasized the importance of addressing social health barriers as a means to reduce health disparities among vulnerable populations (most notably, the Social Need Screening and Intervention (SNS-E) and 42 CFR 422.101(f)(1)(i)). Because of this growing interest in health equity, much research is being done to determine just how significantly SDoH barriers are affecting our healthcare system and health outcomes. Recently, Humana partnered with San Diego State University’s School of Public Health for a cross-sectional analysis of over 21,000 Medicare Advantage beneficiaries with the diagnosis of type 2 diabetes. Researchers hope that findings from the study “may be used to direct interventions to the social needs most associated with T2D health outcomes and inform policy decisions at the insurance plan and community level.”[1] Researchers found a high prevalence of social health needs among Medicare Advantage beneficiaries with type 2 diabetes. There was also a high correlation between the presence of health-related social needs (HRSNs), lower quality care, and higher healthcare utilization.
Study results showed that over half of the beneficiaries with T2D (56.9%) reported at least one HRSN, higher than the 49.3% prevalence of the broader, non-disease-specific Medicare Advantage population. The most prevalent HRSNs documented were financial strain, food insecurity, and poor housing quality for both Medicare beneficiaries with type 2 diabetes and beneficiaries that were non-disease specific. Among those barriers reported, food insecurity was linked to the highest acute care utilization, including avoidable hospitalization, all-cause hospitalization, and emergency department visits. In addition, loneliness, lack of transportation, utility insecurity, and housing insecurity were all associated with lower medication adherence.
Many factors can negatively impact a member’s ability to manage their T2D, including poor diet, the inability to access/afford adequate medical care, the inability to exercise, and the lack of social support. BeneLynk works hard to combat social health barriers associated with T2D and other chronic diseases. We are experts at getting members enrolled in SNAP and finding them access to other local food programs like food pantries and food delivery services. Our Community Lynk and Community Lynk+ solutions have proven instrumental to thousands of members seeking help with social health challenges. We can also screen members to see if they could be eligible for Medicaid. Dual eligibility can save members a significant amount of money per month by providing payment of their Medicare Part B premium. Money that can later be used to pay for medications, transportation, food, and other necessities.
As research brings to light just how significant SDoH barriers affect care quality, acute healthcare utilization, and health outcomes, it’s clear to see that addressing these barriers positively impacts all involved (providers, plans, and, of course, plan members). If you would like to learn more about Community Lynk+, Dual Lynk, or any of our other solutions, you can reach out to sales@benelynk.com.
About BeneLynk
BeneLynk is a national social care vendor for managed care companies. BeneLynk engages members to understand social determinants of health (SDoH) challenges and to provide professional advocacy to access benefits. BeneLynk removes the barriers to allow members to live their healthiest lives.
[1] Ryan JL, Franklin SM, Canterberry M, et al. Association of Health-Related Social Needs With Quality and Utilization Outcomes in a Medicare Advantage Population With Diabetes. JAMA Netw Open. 2023;6(4):e239316. doi:10.1001/jamanetworkopen.2023.9316