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New research released by WellCare Health Plans, Inc. and the University of South Florida (USF) College of Public Health, Tampa, and published in Population Health Management, reports that healthcare spending is substantially reduced when people are successfully connected to social services that address social barriers, or social determinants of health, such as secure housing, medical transportation, healthy food programs, and utility and financial assistance.
The study, which assessed the impact of social services among Medicaid and Medicare Advantage members on healthcare costs such as physician office visits and emergency department use, reported an additional 10 percent reduction in healthcare costs – equating to more than $2,400 per person per year savings – for people who were successfully connected to social services compared to a control group of members who were not.
The findings add to the growing body of evidence suggesting that support for social service programs and interventions can improve community health outcomes and reduce healthcare spending, especially among Medicare and Medicaid populations who are often challenged by social determinants of health.
“While there is growing recognition that socioeconomic factors substantially affect a person’s health status, this research is an important step toward quantifying how addressing social determinants of health impacts health costs,” said lead author Dr. Zachary Pruitt, USF College of Public Health, Department of Health Policy and Management. “The results of our study show that providing social service assistance relates to significantly lowered healthcare spending.”
Study Details
The study examined medical expenditures associated with 2,718 WellCare Medicaid and Medicare Advantage plan members who accessed WellCare’s Community Assistance Line—a toll-free, nationwide line open to the general public. The Community Assistance Line is part of WellCare’s broader Center for CommUnity Impact program and works to match both members and non-members with unmet social service needs to resources through a nationwide network of nearly 200,000 community-based public assistance programs.
All study participants called the Community Assistance Line between January 1, 2015 and March 1, 2016 and identified at least one unmet social need and received at least one referral to a social service organization. Program representatives followed up with all participants to confirm if their identified social service needs had been met.
Researchers then compared the medical claims data of those who reported their social service needs were met compared to a control group of people who reported their needs were not met. In looking at two years of data (one year before the referral and one year after the referral), the study found an additional 10 percent reduction in healthcare costs for those who were successfully connected to social services, equating to more than $2,400 per person per year savings.
“These results provide evidence supporting the vital work we do in connecting our members with the resources and services they need to manage their health,” said Pamme Lyons-Taylor, vice president, WellCare’s Center for CommUnity Impact. “We cannot address a person’s health problems in a vacuum; improving health depends as much on taking care of those basic human needs as it does on providing quality medical care.”
This research is the second in a series of studies being conducted by WellCare and USF on the impact addressing social determinants of health has on both a member’s health outcomes and associated healthcare cost savings.
About WellCare Health Plans, Inc.
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. The company serves approximately 4.3 million members nationwide as of March 31, 2018. For more information about WellCare, please visit the company’s website at www.wellcare.com
About USF College of Public Health
The University of South Florida College of Public Health is currently ranked #1 in Florida and 16th in the nation by U.S. News & World Report. The College of Public Health offers undergraduate and graduate education programs in public health and health administration. College of Public Health faculty engage in a wide array of public health research that directly impacts its local, state, national, and international communities.
SOURCE WellCare Health Plans, Inc.
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