Excerpt
Abstract
Objectives
To evaluate whether a screening assessment tool that identifies
medical and social risk factors is predictive of healthcare costs in the
absence of claims data. To evaluate the effectiveness of screening
for social factors to target high cost beneficiaries.
Study design
A retrospective study evaluating medical and pharmacy claims
costs a year after the behavioral and social risk assessment was
performed.
Methods
We analyzed medical and pharmacy claims, medical and social
risk assessment information, and patient enrollment data for 7,762
newly-eligible Medicaid adults. We controlled for age, gender, and
common chronic diseases. We performed multivariable regressions
across cost and utilization outcome measures, created risk stratification
groups and assessed hospital utilization and spending based on
the number and type of social factors.
Results
Although many managed care networks do not systematically
collect social and behavioral risk factors in a medical setting, social
risk factors are associated with an increase in healthcare costs.
Healthcare costs were $65 Per Member Per Month higher for beneficiaries
who had trouble securing food, clothing, or housing (95%
Confidence Interval [CI], $10 to $119; P=0.02). The presence of 1-3
addressable risk factors is associated with $132 higher Per Member
Per Month spending, even when both groups reported infrequent
hospitalizations (95% Confidence Interval [CI], $77 to $188; P<0.001).
Conclusion
Social risk factors lead to an increase in healthcare cost and utilization
even after controlling for past hospital utilization, chronic conditions,
age, and gender. Managed care networks should routinely
screen for social factors to target at-risk patients to better manage
long-term healthcare costs.
Keywords: Care management solutions; Medicaid expansion; Social
determinants of health
MHNU Corporation d/b/a Medical Home Network (hereinafter “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.
These terms of use are entered into by and between you (“you” or “user”) and MHN. The following terms and conditions, together with our Privacy Policy, incorporated herein by reference (collectively, these “Terms of Use”), govern your access to and use of the Website, including any content, functionality and services offered on or through MHN’s Website. These terms of use apply however the Website is accessed or used, whether through personal computers, mobile devices or otherwise, and includes any applications or other downloads from MHN.
Please read the Terms of Use carefully before you start to use the Website or any services, content, information, or goods provided through or in connection with the Website. By agreeing to the Terms of Use, you accept and agree to be bound and abide by these Terms of Use and our Privacy Policy, incorporated herein by reference. If you do not want to agree to these Terms of Use or the Privacy Policy, you must not access or use the Website.
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. By using this Website, you represent and warrant that you are of legal age to form a binding contract with MHN. If you are not 18 or older, you must not access or use the Website.
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Gail Vijuk, Controller
MHNU Corporation
180 N. Stetson Ave., Suite 600-1
Chicago, IL 60642
312.274.0126
gvijuk@mhnchicago.org
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b. Arbitration. EXCEPT FOR DISPUTES THAT QUALIFY FOR SMALL CLAIMS COURT, YOU IRREVOCABLY AND UNCONDITIONALLY WAIVE ANY RIGHT YOU MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY LEGAL ACTION ARISING OUT OF OR RELATING TO THE WEBSITE OR THESE TERMS OF USE. IF A DISPUTE ARISES OUT OF OR RELATES TO PORTAL OR THESE TERMS OF USE AND THE PARTIES FAIL TO SETTLE THE DISPUTE THROUGH NEGOTIATION PURSUANT TO SUBSECTION (A), MHN MAY ELECT, AT ITS SOLE DISCRETION, TO SUBMIT THE DISPUTE FOR BINDING ARBITRATION IN ACCORDANCE WITH THE AMERICAN HEALTH LAWYERS ASSOCIATION ALTERNATIVE DISPUTE RESOLUTION SERVICE RULES OF PROCEDURE FOR ARBITRATION BY A SINGLE ARBITRATOR WITH EXPERIENCE IN HEALTH INFORMATION TECHNOLOGY AND CLINICALLY INTEGRATED NETWORKS. THE ARBITRATOR WILL CONDUCT HEARINGS, IF ANY, BY TELECONFERENCE OR VIDEO CONFERENCE, RATHER THAN BY PERSONAL APPEARANCES, UNLESS THE ARBITRATOR DETERMINES UPON REQUEST BY YOU OR BY US THAT AN IN-PERSON HEARING IS APPROPRIATE. ANY IN-PERSON APPEARANCES WILL BE HELD AT A LOCATION WHICH IS REASONABLY CONVENIENT TO BOTH PARTIES WITH DUE CONSIDERATION OF THEIR ABILITY TO TRAVEL AND OTHER PERTINENT CIRCUMSTANCES. IF THE PARTIES ARE UNABLE TO AGREE ON A LOCATION, SUCH DETERMINATION WILL BE MADE BY THE ARBITRATOR. IF YOU ARE ABLE TO DEMONSTRATE THAT THE COSTS OF ARBITRATION WILL BE PROHIBITIVE AS COMPARED TO THE COSTS OF LITIGATION, MHN WILL PAY AS MUCH OF YOUR FILING AND HEARING FEES IN CONNECTION WITH THE ARBITRATION AS THE ARBITRATOR DEEMS NECESSARY TO PREVENT THE ARBITRATION FROM BEING COST-PROHIBITIVE.
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WITH THE EXCEPTION OF ANY OF THE LANGUAGE ABOVE IN THIS DISPUTE RESOLUTION PROVISION RELATING TO THE WAIVER OF CLASS AND REPRESENTATIVE ACTIONS, IF A COURT DECIDES THAT ANY PART OF THIS DISPUTE RESOLUTION PROVISION IS INVALID OR UNENFORCEABLE, THE OTHER PARTS OF THIS DISPUTE RESOLUTION PROVISION SHALL STILL APPLY. IF A COURT DECIDES THAT ANY ASPECT OF THE LANGUAGE ABOVE IN THIS DISPUTE RESOLUTION PROVISION RELATING TO THE WAIVER OF CLASS AND REPRESENTATIVE ACTIONS IS INVALID OR UNENFORCEABLE, THEN THE ENTIRETY OF THIS DISPUTE RESOLUTION PROVISION SHALL BE NULL AND VOID. THE REMAINDER OF THE AGREEMENT WILL CONTINUE TO APPLY AND BE UNAFFECTED BY THIS SEVERABILITY PROVISION.
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If any provision of these Terms of Use is held by a court or other tribunal of competent jurisdiction to be invalid, illegal or unenforceable for any reason, such provision shall be eliminated or limited to the minimum extent such that the remaining provisions of the Terms of Use will continue in full force and effect.
These Terms of Use and any separate agreement you may have to use the Website constitute the sole and entire agreement between you and MHN with respect to Website and supersede all prior and contemporaneous understandings, agreements, representations and warranties, both written and oral, with respect to Website.
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.