Expanding the Definition of Preventive Care to Include the Social Determinants of Health

By Sabina Loscalzo

While politicians argue over the fate of the Affordable Care Act and whether private insurance companies or the government should provide Americans’ health insurance coverage, we may be missing an opportunity to reduce costs and help people live healthier, happier lives. And that opportunity is preventive care. But not just preventive care as defined by our current health care system – an expanded definition that includes the social determinants of health: housing, food, education, and employment.

People agree that preventive care works

Why do you think every medical plan these days covers preventive care at 100%, with no deductibles and no copays? It’s because most people understand that preventive care can help them stay healthier. And, if people don’t have to pay for it, they’ll use it; they will go to the doctor and get a physical, immunizations and screenings to keep them healthy and catch issues early. It’s also because preventive care works, and everyone – doctors, insurance companies, and politicians alike – understand that, even if they just look at the numbers.

People who are unhealthy cost the system more money than those who are healthy. In fact, according to a recent article:

• The sickest 5% of the population contribute 50% to the total cost of health care; but
• The healthiest 50% only contribute 3% to the nation’s health care costs*

Expanding what we mean by preventive care

Preventive care is described as the care you receive to prevent illness and disease. However, to truly prevent illness and disease, we often have to look beyond medical conditions. The root cause of many illnesses and disease — especially in elderly or those in lower income brackets — is unhealthy living conditions, or lack of access to nourishing food, steady employment, or education, and the stress around these factors. If health insurance covered preventive care that included screenings and treatment for these non-clinical “conditions” as well as the medical causes, we would see a huge reduction in the number of sick people and the cost of health care overall.

Why do we treat clinical and non-clinical preventive care differently?

Insurance companies cover the cost of mammograms to catch cancer early and help patients get healthy more quickly. So, why don’t they cover services that would help people find better housing that is free of mold, asbestos, and other harmful substances? Those services could prevent asthma and other lung diseases. Some cover lab work to screen for cholesterol and heart disease, but don’t cover services that give people access to nourishing food, which is a big factor in preventing those issues. Since the social determinants of health can have such an impact on a patient’s health – and the cost of health care overall — why are we not covering them as preventive care?

Coordinating all types of preventive care

These days, it is easy for a doctor to send patients to a nearby provider who can test blood or screen for common illnesses or issues. It may not be as easy for them to find a provider outside the four walls of their clinic who can help a patient find affordable, clean housing, or a provider who can help them find a good job that will allow them to eat healthy food regularly, thus reducing their stress levels and keeping them healthier overall.

A digitally inter-connected health and human services network, like those designed by Unite Us, is a good place to start. Our network platform allows providers of all types to seamlessly work together, supporting individual patients by integrating their services (clinical and non-clinical), tracking the patient’s total health journey, and reporting to each other in a collaborative ecosystem.

Here’s how a Unite Us network works – and works well

Imagine that a health care provider saw an elderly woman for a routine physical. The woman had lost significant weight since last year, and the provider asked her about it. The woman admitted that she couldn’t afford to buy much food because her rent had increased and her Social Security payments barely covered her medication. The provider asked about her living conditions and if there was a way to move somewhere a bit less expensive. The woman didn’t know.

With access to the Unite Us network, the provider could help. Here’s what happened:

• The provider went into the Unite Us network, created a client profile and completed the relevant assessments for the patient.
• The network generated two referrals: (1) to a housing provider in the network; and (2) to a benefits specialist to help the patient enroll in SNAP benefits to address her food insecurity.
• Both referrals were accepted within 1 hour, setting up appointments for the elderly woman with a housing provider, who helped her find affordable housing, and a benefits specialist, who helped her enroll in SNAP.
• Not only were the patient’s multiple, co-occurring needs addressed, but the original healthcare provider, housing provider, and benefits specialist all have access to their shared patient and her total health journey, so they can work together to keep her healthy.

Unite Us is a veteran-owned technology company that was initially founded to help veterans, but has since expanded its reach to help communities across the United State, including those supporting the elderly, low-income, and previously incarcerated populations.

To learn more contact Unite Us at 1-844-786-4838 orfill out your information here!