The connection between social determinants and health care costs

“Improving health depends as much on taking care of those basic human needs as it does on providing quality medical care.”

People’s health may greatly benefit when they are connected to social service programs that help them secure housing, healthy food, transportation to their doctor and assistance with their utility bills and other finances, according to the research study, “Expenditure Reductions Associated with a Social Service Referral Program,” published in Population Health Management.

The study, conducted by WellCare Health Plans Inc. and the University of South Florida College of Public Health, Tampa, reviewed the medical expenditures associated with 2,718 WellCare Medicaid and Medicare Advantage plan members who called WellCare’s Community Assistance Line. The toll-free line provides referrals to locally based public assistance programs for anyone with unmet social service needs.

Researchers examined two years of medical claims data (before and after the referrals) of those who reported their social service needs were met, and compared the group’s mean health care expenditures to a control group of people who reported their needs were not met.

While both groups had overall lower expenditures in the second year, there was an additional 10 percent reduction in health care costs for those who were successfully connected to social services — equating to more than $2,400 per person per year savings.

“While there is growing recognition that socioeconomic factors substantially affect a person’s health status, this research is an important step toward quantifying how addressing social determinants of health impacts health costs,” says lead author Zachary Pruitt, an assistant professor at the USF College of Public Health, Department of Health Policy and Management.

The study also demonstrates the merits of a managed care organization having a toll-free line to connect people to community-based resources, adds Pamme Lyons-Taylor, vice president, WellCare’s Center for CommUnity Impact.

“We cannot address a person’s health problems in a vacuum — improving health depends as much on taking care of those basic human needs as it does on providing quality medical care,” Lyons-Taylor says.

Source – Benefit Pro

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