Improving the Healthcare Member Experience
A healthcare plan star rating is determined by three factors – member experience, medical care, and plan administration. In this blog post, we’ll target how healthcare companies can improve the member experience for their older adult population. According to a recent Virgin Pulse Survey, one of the top requested benefits for more senior members in their healthcare plans is supported in staying connected to their friends, family, and community.
“Integrated health and social care for older people contribute to better health outcomes at a cost equivalent to usual care, thereby giving a better return on investment than more familiar ways of working.” -National Institutes of Health
So how can healthcare providers meet their members’ needs? And more importantly, why is it critical to provide this service? Let’s get into the stats and facts.
Loneliness and social isolation in older adults is a condition that affects a large number of the U.S. population, with about 16.9% being ages 65 and older. Baby boomers are leading the demographic shift toward an aging population, but are hoping they have the resources they need to age in place. Resources such as social support are at the top of that list.
As adults age they are more susceptible to living alone, whether they have lost a spouse, their children have moved out, they have retired, or living with a chronic illness. Many factors can lead to someone suffering from loneliness or social isolation. Healthcare companies and older adult communities must work together to help support and remedy this public health issue.
Loneliness and social isolation, are that serious.
Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.
Social isolation was associated with about a 50% increased risk of dementia.
Poor social relationships (characterized by social isolation or loneliness) were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.
Loneliness was associated with higher rates of depression, anxiety, and suicide.
Loneliness among heart failure patients was associated with nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.
- Centers for Disease Control and Prevention
Virtual communities help bridge the loneliness gap, by allowing members to move at their own pace to make connections with others.
As older adults interact with others, whether it's a virtual chat lounge or a live virtual event, their loneliness is more likely to decrease as opposed to their counterparts who do not have frequent social interactions. Virtual communities allow members to get involved from the comfort of their homes without feeling overwhelmed. They can get involved in different events, conversations, and activities with others who share similar experiences and interests.
Being part of a community in general provides a sense of belonging which has a direct impact on your health and well-being. Additionally, it has a long-term impact on leading a healthier and more active lifestyle.
“Virtual communities can provide the needed services to a broader population (i.e geographically isolated or unable to get out to other services) for a much lower cost than many other in-person models.” - Bob Alber, Chief Growth Officer, SecureSeniorConnections®
Healthcare providers have the opportunity to meet their members’ social health needs by investing in virtual community access.
Medicare and Medicaid providers face a few challenges when it comes to providing comprehensive care for their older adult population. Mainly dealing with the competition of new entrants in the healthcare plan industry, which offers age-inclusive benefits to their members. Therefore leaving MA plans with challenges in member retention, attracting new members, improving star ratings, disenrollment rates, and the high cost of member acquisition.
“Isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings.” - National Library of Medicine
Many studies link the social well-being to the mental and physical health of older adults as well as morbidity and illness rates. In this case, the solution which virtual communities offer helps bridge the gap between member loneliness and healthcare plan benefits.
Works Cited and further reading:
Epping-Jordan, J., Pot, A. M., Kelley, E., Toro, N., Thiyagarajan, J. A., & Beard, J. R. (2017). Organizing integrated health-care services to meet older people’s needs. Bulletin of the World Health Organization, 95(11), 756-763. https://doi.org/10.2471/BLT.16.187617
Shaw JG, Farid M, Noel-Miller C, Joseph N, Houser A, Asch SM, Bhattacharya J, Flowers L. Social Isolation and Medicare Spending: Among Older Adults, Objective Social Isolation Increases Expenditures while Loneliness Does Not. J Aging Health. 2017 Oct;29(7):1119-1143. doi: 10.1177/0898264317703559. Epub 2017 Sep 17. PMID: 29545676; PMCID: PMC5847278.
America’s Health Rankings. https://www.americashealthrankings.org/explore/senior/measure/pct_65plus/state/ALL
Centers for Disease Control and Prevention. https://www.cdc.gov/aging/publications/features/lonely-older-adults.html
Conservatory Senior Living. https://www.conservatoryseniorliving.com/senior-living-blog/top-benefits-seniors-will-reap-by-joining-an-online-community/