As the year draws to a close, this holiday season shows a widening wealth gap between our country's wealthiest and most vulnerable populations that is the largest it has been in decades.
For low-income and vulnerable populations, this means inability to pay for food and rent—much less holiday gifts or even needed prescription medications. To care for the health of these individuals, health plans and providers need to create care plans that address these social determinants of health.
A reported 30% of charitable giving happens in December. That being said, many charities are reporting that the need for basics like food, clothing, and health care has more than doubled since the start of the pandemic. Kenneth Hodder, the national commander of the Salvation Army, shares with the Washington Post:
"Eight million people have fallen into poverty during the pandemic. You combine that with food insecurity and a decline in available jobs, then add in lockdowns, evictions, and utility problems, and it is simply a relentless tsunami."
Many other charities and food banks are functioning at maximum capacity, with 80% of food banks reporting serving more people now than a year ago. In addition, Feed America reports that 40% of its visitors this year were visiting the food bank for the first time.
While it's well documented that social determinants of health like food insecurity significantly impact an individual's health outcomes, as poverty and food insecurity become some of the country's leading health issues and charitable organizations are unable to keep up on their own, the onus falls on healthcare providers to provide more support in identifying and addressing food insecurity in their members.
Even among known-vulnerable populations such as Medicaid and Medicare, food insecurity often goes unnoticed until its effects are well underway.
Rather than waiting until the next check-up when an individual comes in, severely underweight—or enters the emergency department and requests extra portions of food for him or herself, and the individual's accompanying family—healthcare payers and providers can identify potential food insecurities earlier through more regular monitoring and check-ins.
For example, when individuals are enrolled in daily programs like Wellth, a missed daily check in can flag the beginning of a problem. Was the member unable to take a prescribed medication because it needed to be taken with food—and there was none? Or was a healthy meal not logged because the member only has money for cheap calories, rather than important nutrients? If the pattern continues for two or three days, the provider or social worker assigned to the member could be notified to follow up—allowing for quicker intervention and better member results.
In recent years, studies have examined multiple ways to lift low-income communities with varied results. One of the most effective strategies? Simply pumping money back into these communities.
In one study by Edward Miguel, economist at University of California, Berkley, even a simple one-time cash grant had significant impact on impoverished communities. The money, which went primarily toward food and other essentials, also resulted in better returns for the local businesses, strengthening the economy and leading in time to better jobs and earnings for those living in the community. At the end of the day, every dollar of aid "increased total economic activity in the area by $2.60."
The take away? A little can go a long way in beginning to close the gaps we see for members with social determinants of health.
Programs like Wellth allow plans and providers to give back to their members meaningfully through financial incentives that can be used toward necessities such as food, rent, utilities, gas, prescriptions, and more. As our members share:
You do not have any idea how useful these rewards are for me. During these uncertain times in our world, I felt lucky to have some help from the Wellth program. I used the rewards card to go to the supermarket and to buy groceries.
-Maria, Nogales, AZ
The rewards I earned using Wellth also helped me treat my family. I went to Costco and went shopping for my whole family. It felt great to be able to provide and give back to them and was a beautiful moment of satisfaction for myself.
-Carolina, Rialto, CA
I am part of a low income population. We work so hard every day for a basic salary. It is hard to be able to afford many things. We need to pay for rent, electricity, food, and medications. With the rewards I received, I was able to buy shampoo, soap, some groceries, and vitamins. I feel that it is really beneficial to have this kind of program available for us since it creates healthy habits for us and at the same time helps us have a better quality of life.
-Carlixta, Brooklyn, NY
Effectively addressing social determinants of health can start with little things—like meaningfully incentivizing care plan adherence to improve member health. And as CMS and other organizations grow to understand and acknowledge the impact of social determinants of health, policies are being made that help make funding these projects more affordable, such as including financial incentives as approved MLR costs.
Healthcare systems are uniquely situated to make a significant impact on addressing vulnerable members in their communities. Programs like Wellth can help through facilitating regular check-ins to identify potential problems early-on, and giving back to these communities through financial reward programs. Learn more today!