Health plans

Health plans can help combat the loneliness epidemic of older Americans

The Covid-19 pandemic has been incredibly devastating for older Americans. Not only because they face an increased likelihood of death and complications from the virus, but also because of the lockdowns and social distancing that have pushed them indoors and alone. Indeed, during the pandemic more than half of older people said they felt socially isolated, up from just 27% before the pandemic.

Even though vaccines allowed many pre-pandemic activities to resume safely, we must not forget the social and community needs of our most vulnerable populations, especially now during the coldest winter months with a wave of cases caused by Omicron. Chronic loneliness isn’t just about feeling lonely – it’s a health risk that profoundly affects the mental and physical well-being of older adults, and we must do everything we can to address it.

It’s well established that loneliness is as much a risk factor for physical well-being as it is for chronic illnesses like heart disease or diabetes. In fact, isolation among the elderly is linked to a four times increased risk of death, 68% increased risk of hospitalization and 57% increased risk of emergency room visits. In addition to this, according to National Institute of Healthcare Management (NIHCM) Foundation, the federal government spends $6.2 billion a year on care related to the social isolation of the elderly. Despite the serious health consequences – and associated costs – the healthcare system remains an underutilized partner in the prevention, identification and intervention for social isolation in older adults.

Currently, most of the services and supports that exist to address social isolation come from fragmented groups of volunteers and nonprofits, or from family members and friends. This is partly because the Centers for Medicare & Medicaid Services Only recently gave the green light to Medicare Advantage (MA) plans to provide a broader range of benefits that address the social determinants of health. With this new charge, it’s time for healthcare payers to join the fight against loneliness. Health plans have access to information about their members that can inform a more coordinated strategy to address isolation, more than any other group could alone. They usually have the scale and resources to reach seniors. And to top it off, many health plans — such as MA plans — have a financial incentive to prevent social isolation.

Additionally, as the lines between payer and provider organizations blur and give rise to a new generation of payvidor organizations, these integrated models of care offer new pathways through which the social determinants of health, such as isolation, can be addressed.

First, plans can identify who is most at risk of isolation and loneliness, for example, by determining if an older person lives alone, if a spouse has recently died, or if their care team has expressed concerns. They also have direct lines of communication with primary care physicians, data on transportation access, insight into members’ socioeconomic status, and self-reporting options to identify affected individuals. Some MA plans use human “care guides” to help their members navigate health care and payvidors have in-house care teams, both of which can identify members with symptoms of depression Health Risks (HRA) or use words like “lonely, alone, isolated” in communications with the plan.

Once those at risk have been identified, there are many ways to ensure connectivity. There are specialist providers who will connect seniors with a ‘Pal’ for general companionship and assistance with daily tasks. Many MA plans have covered the cost of gym memberships or classes designed to improve physical health and build relationships, but few have invested in comprehensive strategies to keep members socially engaged over the long term.

Sometimes all you have to offer is a way for seniors to meet on a more authentic level beyond what social media can offer, a challenge when the world of work disappears from their lives and it’s more difficult to move. The goal is not just to offer a way to get them to know each other, but to use peer relationships as health-promoting tools to help protect against the negative physical and mental impacts of isolation. .

An example of the above is the project to launch virtual social clubs, which in our experience leads to great engagement from participating seniors. That’s not to say that implementing a more robust social program like this will be straightforward. A serious hurdle health plans will need to overcome is that many members don’t see their plan as a true partner in their health journeys. As plans expand services to address social determinants of health, such as isolation, they will need to build trust with members who may be skeptical of this type of commitment from their insurer. .

Loneliness is a condition that requires no leaps in science or expensive technology to cure it, but it is essential to the health of older Americans. There is currently a Medicare Advantage boom, and the flexibility granted by the government leaves room for experimentation and creative thinking when it comes to developing programs specifically to address isolation. It is time for health payers and payvidors to seize this moment for the health and well-being of all our seniors.

Photo: FG Trade, Getty Images