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Resource

Webinar: How Medicaid Plans are Addressing Today’s Social Determinants

Dr. Mark Bloom, VP, Medical Affairs & CMO of Molina Healthcare of Florida and Dr. Bruce Himelstein, VP, Utilization Management Physician of AmeriHealth Caritas joined Vital Decisions in July for a conversation about how their Medicaid health plans are approaching care for their most vulnerable populations.

Highlights:  

Lessons learned in the pandemic to make care more accessible?

MB: Well the COVID epidemic has certainly accentuated all of the social barriers that our members and the Medicaid world face. Our membership had a tough time in the normal circumstances, so our job has been to identify those additional barriers and help them overcome them the best we can, starting with helping them make arrangements to get care, and reminding them of the importance of the care they need to be receiving.

BH: We just see the magnification of years of unfortunate racial, ethnic and economic disparities and injustices that are endemic in our culture: The severity of illness and mortality rates, vaccination rates are substantially lower, vaccine hesitancy is higher. And so it gives us a chance to continue what we do, which is educate and equalize, and provide the same quality of care to anybody who’s covered by our health plan. Identifying those barriers, trying to enlist our membership not to defer care, and then really accentuate the use of different methods of communication. The use of telehealth and video based medicine has become very important to our members and our connectivity with the community.

We continue to use community connections, and that can be social. It can be based on where you live by zip code. It can be based on your faith community. I’m very excited about our connections with barbershops that are promoting vaccinations and adding a whole new level of connectivity and engagement with our members.

MB: As availability of the vaccine for age groups came down, the corner drug stores became options. And we provide free transportation to those members who needed it.

 

Strategies, programs and approaches that build trust in our healthcare system?

BH: The key is understanding what we call the hierarchy of needs. What are the things that our members really need in order to address our underlying health problems? If you don’t have a roof over your head, it’s very hard to manage diabetes.

So building a trusting relationship really gets at what we can do to help them. So it may be finding housing. It may be finding faith-based resources. It may be finding food. In the pandemic this has become much more complicated because of social distancing, but that’s how we do it.

MB: We try to circumvent things for them. We’ll have someone swing by the house and drop off food. They realize that we are there for them in ways that perhaps they didn’t know before. We reach out to them because we’ve seen that they stopped getting treatment or preventive care, and they have a chance to tell us what’s going on and we have ways of helping them.

How should diversity, equity (DEI) shape communication and outreach philosophies?

BH: We hire staff who come from the communities we serve. Many of them are not necessarily clinical folks — but they have a foot in the community and are aware of the social issues of those communities and the resources we can bring to it. These are people who speak the same languages who come from the same cultures, same ethnicity, same background.

MB: And just answering the phone can be intimidating. When the company name or an 800 number comes up, they won’t answer the phone. So we encouraged our staff to drive by and meet members in person, tell them their cell phone number so they’ll recognize the caller ID. And in these ways, we build the competence so that members will avail themselves to the services we can provide for them.

BH: Our team from top to bottom and sideways at AmeriHealth represents and lives in those communities that we serve. We’re diverse by intention and even more, diverse by action to meet those member needs.

 

Watch the full webinar recording: