Streeterville and Englewood Chicago are nine miles apart, yet from a health perspective the distance between is nothing short of shocking.
Life expectancy in Streeterville is 60 years, and in Englewood it is 90 years! Access to quality healthcare, or lack thereof, plays a dramatic role in living a full life, as does housing, transportation, and quality foods. An individual’s neighborhood, education, and income can influence life expectancy and the potential to develop chronic medical conditions.
Health insurance companies are assisting employer groups by leveraging data to pinpoint areas where employees are underutilizing benefits. Once problem areas are identified such as lack of childcare or restrictive hours at urgent care centers, the employer and insurer can help employees make the best use of their health insurance benefits, and possibly create programs to address the need.
Those in less affluent neighborhoods use emergency rooms twice as often as affluent neighborhoods, miss work six or more days a year, and are five times likelier to report a mental health issue. Financial insecurity and a sudden medical bill often result in choosing between medical care and food. Poor air quality in certain neighborhoods exacerbate asthma symptoms which lead to more medical issues and affect life expectancy. Rural areas, where poverty and unemployment are typically higher, access to social services may be few and far between.
Employers now have access to employee health data (personal identification information removed) such as total medical, prescription, specialty claims, clinical claims, and well-being information. This demographic information can be used to improve health outcomes and manage costs. As an example, if a certain number of employees continue to visit emergency rooms instead of less costly urgent care centers, the employer can send out an email blast listing all urgent care centers nearby, hours, and co-pay amounts for services compared to an E.R. visit.
Arizona health insurance companies are now able to supply to employer groups predictive analytics to proactively identify employees who may be dealing with issues affecting their health. Insurers use de-identified claims data from its members to identify groups that may need assistance with housing or nutritious food. Again, specific employees are never identified. The goal is to offer richer benefits to address these needs and to offer guidance to help employees get the most out of their health insurance coverage.
After one particular health insurance company analyzed ER use and hospitalizations, they were able to identify those struggling with hunger, homelessness, and safety. This information was then used by the employer group to create programs to help address these needs. In Baltimore, mammogram screening was at an all-time low based on claims data. It was determined that the reason why screenings were so low is because single parent households were concerned about the cost of childcare while at the appointment. The local insurance companies and employers funded a mobile mammogram program and screenings are up.
The future of healthcare and health insurance is using a whole person approach by understanding an individual’s needs.