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Food insecurity affects millions, making it one of the most challenging social determinants of health. How can clinicians, payers and community-based organizations work together to bring relief to members experiencing hunger?
This year, more than 33 million Americans are struggling with food insecurity. One in 26, or 3.8 percent of all US households, regularly limit or skip meals because they cannot access or afford enough food.
Children, people living in rural areas, and racial and ethnic minority groups are taking the hardest hit due to vast food deserts, high costs of living and other ongoing economic impacts of the COVID-19 pandemic.
Food insecurity is just one piece of the complicated web of social determinants of health (SDOH) that are closely correlated with poor clinical outcomes and higher costs for providers and payers.
Individuals affected by food insecurity are less likely to be able to afford routine healthcare services and prescription drugs to keep them healthier, and may be more likely to delay necessary care until an illness reaches a much more serious, difficult and costly state.
In late September, the White House Conference on Hunger, Nutrition and Health brought together a slate of national experts to discuss the deeply rooted challenges of food insecurity and develop new strategies for addressing access to fresh, nutritious and culturally acceptable food.
AdhereHealth was proud to participate in this important event to share our experiences with addressing food insecurity and other SDOH factors, promoting medication adherence and patient empowerment to ultimately foster better health outcomes for vulnerable individuals.
“Our mission is to improve medication adherence, but we can’t do that without identifying and addressing the real issues behind why a person is not taking their medications as prescribed,” explained Cyndi Alexander, AdhereHealth’s Chief Adherence Officer, during a virtual satellite session entitled “Crossroads of Health & Hunger: A National Ecosystem.”
“So often, medication non-adherence is not purely a clinical problem. It’s the social determinants of health that are preventing people from paying for their medications, understanding how to take them and accessing them consistently.”
For many people, maintenance medications for chronic diseases—or even prescriptions for more acute needs—don’t seem as essential as putting food on the table. Until the healthcare system can help people with their fundamental needs, including food, housing and personal safety, medication adherence is likely to remain last on the list.
“People experiencing really dire socioeconomic issues, the types of issues we find at the root of Maslow’s Hierarchy of Needs, aren’t going to engage with the healthcare system in the same way as more affluent health plan members,” Alexander said.
“The first step of outreach to these communities is to develop trust. We do that through motivational interviewing and regularly checking in on these members—not just with empathy and non-judgment, but also with real, tangible resources to help them with these difficult issues.”
Unfortunately, finding local resources to meet specific needs can be challenging, Alexander said, because the traditional healthcare industry is just starting its journey toward working effectively with community-based organizations, like US Hunger, Feed Forward and United Against Poverty, all of whom joined the virtual session.=
“There are great networks out there, like FindHelp.org, but not everyone is listed on that site. Currently, there is no good national place for us to go find all of those resources that may be available.”
Health plans offer a number of benefits aimed at SDOH issues, including transportation benefits and AdhereHealth has integrated personalized benefits insights into our member outreach workflows, allowing our trained digital pharmacy experts to connect members with everything they are entitled to.
“However, the challenge with socioeconomically insecure individuals is that there are so many things affecting their lives,” noted Alexander. “The issue today is not necessarily going to be the same issue as yesterday.”
“We need a better mechanism for connecting members with services after they’ve used all of the benefits their health plan provides. We have to build better digital connections and better partnerships locally, regionally and nationally so we can connect people with every type of service or support that they need to them up so they can start focusing on medication adherence and health maintenance.”
Healthcare stakeholders, community-based organizations and government agencies are actively working on the problem of closing the loop between members, health plans, clinical care providers and non-profit groups.
The solution lies in a combination of policy changes, technical upgrades and enhanced alignment of business incentives through strategies like value-based care.
In conjunction with the conference, the White House has announced its new National Strategy on Hunger, Nutrition and Health to encourage collaboration and reach the goal of ending hunger in America by 2030.
Technology partners like AdhereHealth, with our deep connections in the Medicare Advantage and commercial health spaces, will play a crucial role in achieving this important goal as the White House looks to augment nutrition benefits in Medicare and elsewhere.
The Administration is seeking to work with Congress to pilot medically tailored meals for Medicare beneficiaries and additional food security benefits for Medicaid beneficiaries over the next few years.
“Healthy food is medicine,” stated Alexander. “Expanding food security benefits is an excellent idea, especially for members with complex health needs. But medicine is also medicine. We need to supplement these efforts with the infrastructure to make sure that people are also getting access to their prescription drugs. They need to know that they can get their prescriptions delivered to their door. And they need to know how to take those medications correctly.”
“The key for a person with diabetes, for example, will be connecting food-as-medicine with reliable access to the insulin they need to manage their blood sugar so that we don’t just create a different type of silo that leaves people lacking what they need to truly self-manage their health.”
Over the next several years, collaborating across historical boundaries will be crucial for achieving the goal of eliminating hunger by the turn of the decade.
“We need to start thinking outside the box about these issues,” Alexander said. “We must establish even more innovative partnerships across the ecosystem and use advanced analytics to address SDOH needs on the population level and the individual level.”
“If we can start solving for food security at scale, we will be in a much better place to raise medication adherence rates, foster better patient outcomes, and improve the experiences of our most vulnerable populations.”
To learn more about how AdhereHealth helps health plans overcome SDOH barriers to achieve year-round medication adherence, download Raising the Bar on CAHPS Performance or join us for our upcoming webinar on October 19 entitled: 2023 MA Star Ratings: Analysis of Notable Changes.