Health plans could improve outcomes by focusing on education, employment: report

The hotel industry has struggled with a growing pool of open positions and high turnover as the U.S. unemployment rate hovers around 4 percent.
Helping people complete their education and secure jobs can measurably improve their health. (Getty Images/artisteer)

While more states are adding work requirements as a condition to get Medicaid, a new report shows helping vulnerable populations increase their education and find steady work is key to improving health outcomes.

Citing research that shows people with more education tend to have better behavioral health profiles, a new report from the Association for Community Affiliated Plans (ACAP) details innovative initiatives safety-net health plans have undertaken to improve the health of their covered populations. Among the offerings are scholarships, skills training, GED assistance and job placement services.

The report echoed recently released research from the Kaiser Family Foundation (KFF) that correlated education with better health outcomes.

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General literacy appears to correlate to health literacy—the more education people have, the more likely they are to lead healthier lives, see physicians regularly, smoke less and exercise more frequently, the KFF report said. Education is also linked to better employment status, which provides greater financial security, another key contributor to overall health.

The healthcare industry faces key challenges as it seeks ways to improve population health by targeting social determinants, however. Many of these opportunities lie well outside the familiar realm of primary care, so they require cooperative efforts that include healthcare providers but don’t necessarily focus on them. Medicaid offers a logical starting point for collaborative efforts targeting social determinants of health, according to ACAP, serving as a direct connection between the healthcare system and economically disadvantaged populations. That means populations covered by Medicaid plans often overlap with populations in need of educational and labor-support programs. 

This is particularly pertinent information in light of the increasing number of states pursuing 1115 waivers that allow them to require individuals meet certain work requirements to qualify for Medicaid coverage.

“We have long held the tenet that Medicaid helps people be better prepared for employment. Employment shouldn’t be a condition of Medicaid coverage,” said ACAP CEO Margaret Murray said in a statement. “This report shows how Safety Net Health Plans are helping their members to become workforce-ready, and how they go the extra mile to assure that other social determinants such as food and housing are stable so that once their members find a job, they can excel.”

RELATED: Study: Adults impacted by Medicaid work requirements struggle to sustain employment

The ACAP report details the efforts some safety-net healthcare payers have been making in an attempt to rise to the challenge of finding ways to organize and support these cooperative efforts. Among the examples:

  • Community Health Choice has developed a suite of services called CareerReady designed to help its members gain employment. The effort started with a scholarship program to send students to Houston Community College to pursue job certifications. Now, it includes personal coaching and mentorship programs that include mock interviews and job hunt assistance.
  • CareSource offers a program it calls JobConnect, which helps members assess and prioritize their needs. Once members have received the support they need to stabilize their food and housing situations, the program works with them to find educational or employment resources as necessary. The goal is to hook members up with long-term employment opportunities and improve their overall quality of life.
  • Amida Care offers its members in the New York City area the opportunity to build marketable job skills through structured training programs. Members who go through the programs emerge with the tools to take on positions that bolster community health outreach programs, further helping to improve the lives of those in their communities.
  • AmeriHealth Caritas launched Mission GED in 2014 to help its members receive a high school equivalency certificate and further their education. Under the program, members receive personal coaching and AmeriHealth covers pre-test and equivalency exam costs.

According to the report, the key to expanding upon this work will mainly be finding funding to support employment and educational programs run by Medicaid health plans.

ACAP recommends the Centers for Medicare & Medicaid Services and individual states work together to create and fund innovative pilots that will continue to build a base of evidence for developing best practices and supporting the continued evolution of similar programs. Given the uncertainty around future Medicaid funding, ACAP suggests the longevity of such programs will depend greatly upon locating sustainable funding through demonstration projects, outcomes-based payments or collaborations among federal agencies.

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