At the recent leading industry conference, AHIP 2022, attendees heard much buzz around a range of topics changing how we approach the entire health ecosystem. Driven by the pandemic or awakened by the social dynamics over the last 2.5 years, it is apparent that a focus on health equity, social determinants of health, and behavioral health are essential for a healthier population.
The role of data analytics in addressing health equity
Building over several years, many organizations’ programs are dedicated to serving consumers equally - addressing gender, income, race, ethnicity, sexual orientation, geography, and more in their care and follow-up. Organizations are not only establishing a health equity vision but putting tangible goals and measures to achieve it in place.
Addressing health equity across an entire enterprise can be painstaking work. Successful health equity initiatives can be driven by leveraging data analytics tools supported by artificial intelligence and machine learning (AI/ML) and skilled data scientists. A granular analysis of health equity measures across the organization helps to pinpoint challenges to be addressed. Supported by refreshed protocols, enhanced medical and staff training, and community efforts, the industry is changing its approach to health.
Social determinants lead to a “whole person” care approach
Eighty percent of a person’s health outcome is determined outside the doctor’s office, so it is no wonder that more and more health organizations are looking at the person with a 360-degree view, essentially “whole person care.” Advances in data collection and data synthesis have sharpened our awareness. Socioeconomic factors, including affordable housing and food insecurity, show that health plans significantly impact the entire ecosystem.
Recognizing these social determinants of health is one thing, but tackling them is quite another. The 2022 AHIP conference included a significant call to action for continued policy advances, breaking apart data silos for better information flow, funding, technology, education assistance, and collaboration at all levels. A community approach is advocated, using every mechanism possible – both top-down and bottom-up – to produce public service announcements, conduct phone outreach, go door to door to build trust, promote health literacy, and bring services to the community.
As we consider the whole person, it is not just enough to share medical-to-medical data, the exchange must also include social data, and the data must be shared promptly. Our philosophy and mechanics of care have changed drastically over the decades, and we’re seeing this through the millions of telehealth visits and innovative ways to engage people through mobile mechanisms.
Behavioral health is not a one-size-fits-all approach
The pandemic-driven years of uncertainty, sheltering in place, modified policies and protocols, and school and job disruptions have impacted both young and old. As a result of these factors, millions of people deferred treatments, screenings, and therapy. Studies originating pre-COVID and continuing through 2021 show “good” mental health has declined at least 5% and that nearly 24% of Americans claim their mental health is “fair to poor.” An interesting, underlying theme has exposed loneliness is reaching epidemic proportions, with the most vulnerable group being 18 to 24-year-olds as they deal with stress, anxiety, and depression. These, plus addiction and other mental illnesses, strike all ages.
Experts at the AHIP 2022 conference noted that reimbursement policies, access to therapists across state lines, breaking down the data barriers, and full access to social data are critical to addressing these issues. Behavior health needs must be met where the person is, and it is not a one-size-fits-all approach. Continued innovation in care delivery and the use of predictive models (combining self-reported data, past histories, demographic and social data) are keys to addressing situations before they become more serious.
A roadmap to a healthier population
The road to a healthier population is long, yet the roadmap is becoming more apparent, and those participating in AHIP 2022 shared their vision for progress in several areas:
- Lower costs by streamlining cumbersome processes like prior authorizations and care management operations
- Leverage technology to analyze big data, monitor remotely and consult and advise where previously only face-to-face interactions were possible
- Take a whole person approach to treatment by sharing current, seamless information regardless of the location of their care or insurance status.
- Increase health literacy to help individuals not just receive test results but understand them
- Deploy mobile technologies or leverage more traditional outreach to remind people about their next appointment, screening, or exam
- Prepare for evolving care and payment model as individuals focus on wellness.
- Navigate episodes of care and the events that follow – transitions in care, care management, and health at home
As participants in the health ecosystem, we all play critical roles in reaching our future state. Along that journey, we can reflect to see where we were, how far we have come, and yet how much more there is to do.
I invite you to learn more about CGI’s work in the healthcare industry.