by Eva Powell
ACHP’s member companies have been fixtures in their communities for decades, forging lasting relationships with non-profit organizations, state and local governments and the business community. Community health plans know firsthand that improving physical, mental and economic health depends on an effective network for meeting social needs such as food insecurity, transportation and housing.
Debate continues, however, about the role of the health care industry, and health plans specifically, in creating and activating this network.
After spending a decade as a hospital social worker, I’ve been among the many in health care asking how we address social needs to get better outcomes, while also making care more affordable. The bright light of COVID-19, compounded by nationwide protests for racial equality, has shown that to be the wrong question. The real question is, how will the industry invest in and support overall health and help eliminate the undeniable fault lines that influence health and wellbeing in the U.S.?
Community-based plans know how critical trust is, especially for engaging people when they are most vulnerable. ACHP member plans are showing us how the industry can better invest in health for all people:
1. They are leveraging their relationships to understand and address the immediate needs of their members and communities.
- UCare is addressing food insecurity with culturally tailored approaches for Somali residents. They are also donating iPads to local partners who are combatting social isolation.
- Dean Health Plan is partnering with a local restaurant group and Epic, a health IT software giant, to offer free weekly meals to seniors in Medicare Advantage.
- UPMC partners with Cultivating Health for Success to reduce unplanned health care for the homeless and those at-risk of being homeless by coordinating and managing care in the community.
- Kaiser Permanente is partnering with Unite Us to connect health care and social services providers to address needs such as housing, food, safety, utilities and more for millions of people across the country.
2. Partnering with businesses and state and local governments, they invest in infrastructure necessary to make health – not just health care – happen.
- CDPHP deployed staff to assist community partners as a result of the COVID-19 pandemic.
- Presbyterian Health Plan partners with the New Mexico Department of Health to provide homeless shelters in local hotels. They also coordinate with the New Mexico Aging and Long-Term Services Department to meet the food insecurity needs of their members.
- UPMC Health Plan has developed a rapid response team with its community paramedicine group to identify vulnerable members with COVID-19 symptoms. Trained paramedics deliver food boxes to members and use their knowledge of how to navigate social services infrastructure to meet members’ needs quickly and safely. When distance is a barrier, they conduct telehealth visits.
3. Their non-profit, community-based model promotes stability and recovery of both health and the local economy.
- Priority Health, HealthPartners and UCare cut executive pay in light of COVID-19 to ensure the sustainability of the health plan and the coverage it provides, while minimizing financial impact on customers and members.
- Harvard Pilgrim has advocated for a sequel to the Paycheck Protection Program to support small and mid-sized businesses with loans, which could be forgiven if they keep workers on their insurance plans.
- UPMC continues to provide access to care in rural areas under a global budget established as part of its participation in a CMMI pilot on rural health. They are also preparing to support Medicaid members through partnerships focused on developing infrastructure necessary for skill-building and job training.
4. They are doing their part to address the systemic, societal factors that are the root cause of health disparities, especially in communities of color and native populations.
- Presbyterian provides information to the State’s Food Insecurities group to ensure outreach to isolated Navajo Communities. They are also developing culturally and linguistically appropriate COVID-19 prevention messaging for its Native American citizens and working with tribal partners to communicate health information.
- PacificSource shifted all 2020 grantmaking to fund direct health care services for vulnerable populations most impacted by COVID-19 and the community-based organizations addressing their social needs.
- HealthPartners and researchers at the University of Minnesota collaborated with developers to create a mobile app that increases the ability to test, isolate and trace the contacts of possible COVID-19 cases at the neighborhood level.
Investments in health have long-term payoffs; very rarely are dividends realized in the short run. The pain and threats sweeping across our nation today are a direct result of prioritizing short-term gain over the long-term health of individuals and communities. Our current crises present an important opportunity to recognize the long-term sustainability benefits of paying for value, since fee-for-service has reinforced our short-sighted approaches.
The COVID-19 pandemic has reminded us that population health is a core competency for health plans, and that preventing and managing chronic illness for all people is foundational to the health and economic security of us all. Now is the time to invest in long-term, relational approaches to health care delivery, coverage and payment, as our current payment model has failed to deliver quality health care that people can afford and the health outcomes they expect. By building on trusted partnerships fostered over decades of investment, ACHP member plans are delivering essential coordinated care and leading their communities to better health and wellbeing.
Additional information on efforts of ACHP plans and their affiliated systems during this public health crisis is available here.