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Study Shows Social Risk Factors are Associated with Increased Healthcare Costs for Medicaid Beneficiaries
Healthcare costs $65 higher per month for beneficiaries who had trouble securing food, clothing or housing
CHICAGO – Social risk factors lead to an increase in healthcare cost and utilization even after controlling for past hospital utilization, chronic conditions, age and gender according to a paper published in the HSOA Journal of Community Medicine and Public Health Care. Beneficiaries who needed help securing food, clothing or housing had healthcare costs that were $65 higher per month than those who do not have these addressable risk factors.
“The need to understand high and rising risk Medicaid beneficiaries is becoming increasingly important as the Medicaid program continues to evolve. As a healthcare community, we need to be able to allocate care management resources in the most effective way with limited resources while ensuring our patients receive the best care,” said Dr. Art Jones, chief medical officer, Medical Home Network.
Many managed care networks do not systematically collect social and behavioral risk factors in a medical setting. However Medical Home Network (MHN) has implemented one of the largest applications of a social risk assessment among a population of newly eligible ACA Medicaid beneficiaries. MHN designed a five-minute risk assessment tool that questions new beneficiaries about health and social risk factors and past emergency department utilization.
“Medical Home Network’s goal was to identify addressable social risk factors in addition to medical issues and prove the predictive value of having care managers address these issues and help prevent those ‘rising risk’ beneficiaries from becoming an even higher cost,” said Christy Lemak, PhD, chair, Health Services Administration at the University of Alabama and the study’s evaluator and author.
The purpose of the study was to explore how medical and social risk factors impact use and spending using Medical Home Network ACO medical and pharmacy claims, medical and social risk assessment information and patient enrollment data from 7,762 Medicaid beneficiaries, who were continuously enrolled twelve months after completing the assessment.
“Medical Home Network determined managed care networks should screen for social factors to manage long-term healthcare costs,” Dr. Art Jones said.
Medical Home Network uses results reported on the risk assessment to allocate care management resources. They deploy a multi-disciplinary, team-based approach that includes care management staff. Each primary care practice collaborates with community partners to address and attempt to resolve the individual’s self-identified barriers to care.
“Our results showed us there is more to a patient than their medical history. Social risk factors allow us to learn more about the patient beyond the clinic walls and as a result we are able to implement a more holistic approach to patient care,” said Beth McDowell, manager of medical analytics, Medical Home Network.
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The title of the study published in HSOA Journal of Community Medicine and Public Health Care is “Predictive Value of Screening for Addressable Social Risk Factors” authored by Art Jones, MD; Christy Harris Lemak, PhD; Cheryl Lulias; Todd Burkard; Beth McDowell and Kylie Severson.
About Medical Home Network
Medical Home Network is transforming health care delivery for Medicaid patients by fostering collaboration and innovation. Our proven model of care unites communities of providers and patients around a common goal: To redesign health care delivery and transform the way care is delivered and managed, resulting in improved patient care, lower costs and better health in the communities we serve. www.MedicalHomeNetwork.org
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MHNU Corporation
180 N. Stetson Ave., Suite 600-1
Chicago, IL 60642
312.274.0126
gvijuk@mhnchicago.org
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Effective Date: January 12, 2017
Revision date 1.6.2017
MHNU Corporation d/b/a Medical Home Network (“MHN”, “we” or “us”) operates one or more websites (the “Website”) in support of its mission to achieve the Triple Aim for traditionally underserved populations -- improving individual experiences with the health care system, improving the health of populations, and reducing costs of care. This Privacy Policy explains MHN’s practices with regard to the use, collection, maintenance, protection and disclosure of information about you when you visit our website. We encourage you to read this Privacy Policy in full to understand our privacy practices before using this website or submitting any personal information.
This policy applies to information that MHN and its affiliates may collect from you:
It does not apply to information collected by:
Please read this policy carefully to understand MHN’s policies and practices regarding your information and how we will treat it. If you do not agree with our policies and practices, you may elect not to use the Website. By accessing or using the Website, you agree to MHN’s Privacy Policy. This policy may change from time to time (see Changes to Privacy Policy below). Your continued use of the Website after we make changes is deemed to be acceptance of those changes, so please check the policy periodically for updates.
The Website is offered and available to users who are 18 years of age or older and reside in the United States of America or its territories. MHN does not knowingly collect information from users under the age of 18. Persons under the age of 18 should not access or use this Website in any manner. If a user under the age of 18 submits information through any part of the Website, and MHN becomes aware that the person submitting the information is a child, we will attempt to delete this information as soon as possible.
1. We may collect several types of information from and about users of our Website when they interact on the Website, including:
Your access to and use of the Website may be monitored by MHN for purposes of operating the Website and testing, performance assessment and evaluation in connection with MHN initiatives.
2. MHN may use and disclose this personal information as follows:
3. MHN will maintain reasonable and appropriate safeguards to prevent unauthorized use or disclosure of a user’s personal information.
Through the Website, users may be able to access other websites or applications owned or controlled by third-parties. MHN is not responsible for the privacy policies or content of those websites. The use and collection of information by these third-parties is governed by their respective privacy statements and is not covered by this Policy. Access and use of such websites, including the content, information or services on those sites, is solely at your own risk. MHN makes no guarantee and disclaims any implied representations or warranties about the accuracy, relevance, timeliness, completeness, or appropriateness of these third-party websites, the information contained in them or the products or services they provide. The use of those third-party websites may subject you to separate binding agreements and privacy statements. The practices described in this privacy policy do not apply to information gathered through those other websites.
We reserve the right to make changes to this privacy policy. It is our policy to post any changes we make to our privacy policy on this page with a notice that the privacy policy has been updated on the MHN home page. You are responsible for periodically visiting our Website and this privacy policy to check for any changes.
We take your privacy seriously. If you have questions, concerns, or feedback regarding the privacy of your personal information, you may contact the MHN Privacy Officer at:
MHNU Corporation
180 N. Stetson Ave., Suite 600-1
Chicago, IL 60601
312.274.0126
compliance@mhnchicago.org
Effective Date: January 12, 2017
Revision date 1.12.2017
In alignment with our mission, Medical Home Network strives to create a work environment that supports equality, diversity of thought, and makes all people feel welcome. As an organization, our core values of equity, equality, diversity and inclusion guide the work we do, the relationships we build, and the way we recruit, develop and retain our people. We recognize this process is a journey, and we stand firm in our commitment to learn and change, champion diversity, and hold ourselves accountable.
Medical Home Network also invests in meaningful programming such as internships and fellowships that help young adults from under-resourced communities gain work experience in order to land quality jobs after college. In addition, MHN provides targeted financial support to community-based organizations that empower, educate and provide opportunities for low-income individuals and families and help them build stable futures.