Elevance Health research outlines ways health plans can fight loneliness in MA beneficiaries

Loneliness can have major impacts on seniors' health, worsening comorbidies and even driving mortality, according to a white paper by the Elevance Health Public Policy Institute.

Loneliness in older adults increases the likelihood of depression and dementia as well as worsening outcomes for individuals with hypertension, heart disease and stroke, according to the white paper.

In a survey, the researchers researchers found that:

  • About 28% of respondents had a mental health condition.
  • About 1 in 4 reported having both depression and another mental health condition.
  • Individuals with a mental health diagnosis were more likely to live alone.
  • Individuals with a mental health diagnosis cited limitations to social activities in the past month because of poor health.

Elevance Health hired research and consulting company Health Management Associates to describe the characteristics of 16,000 Medicare beneficiaries with a mental health diagnosis using the 2018 Medicare Current Beneficiary Survey. Some beneficiaries were covered by traditional fee-for-service Medicare, others by Medicare Advantage (MA).

Jennifer Kowalski, the Public Policy Institute's vice president, told Fierce Healthcare in an email that Elevance Health wants to share lessons the health plan learned about treating social isolation through its Member Connect program, launched in 2017 specifically to combat social isolation for those enrolled in its MA plans.

She called MA’s ability to address loneliness “a differentiator” compared to traditional Medicare.

“First, they are uniquely positioned to identify older adults at-risk of experiencing loneliness through robust data analytics capabilities,” Kowalski said. “Second, they are able to reach out and connect to those individuals through various high-touch channels, such as home health and care management programs. Third, the proven link between loneliness and several social determinants of health means that plans have a vested interest in reducing the experience of loneliness and social isolation among their members.”

The Member Connect team features a community health worker or social care partner and an Elevance Health employee volunteer who serves as a phone pal.

“The approach focuses on establishing personal connections with affiliated MA plan members and supporting them to make changes in activities to reduce isolation and loneliness,” according to the white paper.

Since Member Connect's launch, 5,740 Elevance MA members have participated in the program, and 216,833 phone calls have been made to participants.

The social care partner comes with a social work or counseling background and helps members engage with the program. They try to screen for barriers to connection such as lack of transportation, the recent loss of a partner and mobility difficulties.

The phone pal calls weekly and encourages members to share personal stories and interests but also what assistance they may need for daily living and reports any problems to the social care partner.

The white paper said that “SCPs have assisted with member referrals for fair housing counseling in their communities when their rent has been raised to unaffordable levels.”

To qualify for Member Select, an individual must be able to check off one of the following:

  • Live alone
  • Live with others, but majority of their day is spent in isolation
  • No social support (i.e., long distance caregiver or no caregiver)
  • Self-report loneliness or isolation
  • Is a caregiver with little support
  • Newly widowed with little social support
  • Recent diagnosis of a serious or terminal illness
  • Diagnosis of dementia

The Public Policy Institute said that “while this research did not examine healthcare utilization, the known impact of social isolation on health suggests that these programs could lead to downstream improvements in healthcare utilization.”  

Kowalski explained: “We don’t yet have robust results on the impact of the program on utilization, as this will be more challenging to quantify given the myriad of factors that affect use of healthcare, especially among an older population. Nevertheless, it is a question we’d consider for future research.”