Many factors impact your members and their health. These factors also influence how they engage with and use their health plans. As a Medicare Advantage plan, you likely have many strategies to improve cost containment while ensuring quality care access.
One detrimental condition that health plans are recognizing as a driver of poorer health outcomes is loneliness. Loneliness can significantly affect a person’s mental and physical health, making them more likely to become frequent flyers of emergency departments (EDs) because they don’t engage fully in their health until a crisis emerges.
Experts have called loneliness a “public health emergency,” and this recognition is why Medicare Advantage plans seek to identify and support treatment for loneliness.
Loneliness as a disease
Research on loneliness and its connection to serious health problems is just beginning to get the attention it deserves. Critical insights are revealing that loneliness is more than just a feeling. It's a condition that not only impedes social connections, but also has mental and physical consequences that often lead to or are fueled by numerous health issues.
Data confirms the connection between loneliness and chronic inflammation. It can also impact heart health. A study determined that the risk of heart disease increased by 29 percent and stroke by 32 percent for those with poor social relationships. The same research identified that loneliness affects cognitive function, raising the threat of dementia by 50 percent.
This increased risk of disease and illness is only one part of the challenge for your Medicare Advantage plan. The other aspect is how lonely members engage with your plan.
Lonely people use more healthcare resources
Lonely people interact with their plan differently than others, often declining health plan outreach for care coordination and waiting until their health deteriorates leading to ER visits and hospitalizations. Connecting members to plan resources and helping them engage more at the right time supports better outcomes and member satisfaction with the plan.
Research reveals that older adults who are objectively isolated have higher expenditures associated with increased usage of hospitalization and institutionalization. Further, the American Association of Retired Persons (AARP) conducted a study that attributed a lack of social connections to $6.7 billion of wasted Medicare spending annually. Reining in or eliminating these costs — and delivering proven programs to address loneliness — is now a priority.
Medicare Advantage plans address loneliness here and now
Rising awareness of the costly and harmful impacts of loneliness has driven health plans to address it. Cigna produced a 2020 Loneliness Index, reporting that Americans experience loneliness on a chronic level. The reasons include, living alone, an absence of regular and meaningful social interactions and poor quality of health.
With these findings, Medicare Advantage plans launched programs to target loneliness. Those programs were loose in configuration, creating difficulties in scaling. In 2022, Cigna released more data on loneliness as a condition and its current state as an “epidemic.” This data further emphasizes the need to address and treat this complex disease.
The Centers for Medicare & Medicaid Services (CMS) have also attempted to help Medicare in this area. They now authorize a range of benefits to address social determinants of health (SDOH). SDOH needs and loneliness are often intertwined.
These programs can be a good start. However, they don’t chip away at loneliness or isolation. For plans to target loneliness successfully, a treatment plan that is scalable, human-centered and results-driven is essential. This approach has enabled plans to improve cost containment as well as mental and physical health improvements for their members.
Reducing and treating loneliness with empathy-driven technology
If you are ready to address loneliness, the right program could make a difference. Plans that effectively address loneliness implement programs that work for their entire population. Medicare Advantage plans are employing Pyx Health to provide these services through empathy-driven, accessible technology to complement human connection.
Pyx Health allows members to interact with technology and provide feedback while having unlimited access to a compassionate support center. With support center agents, members can freely talk without judgment, strengthening their engagement. Our mix of tech and human touch drives real results, including decreased emergency department visits, increased visits to other care settings and greater adherence to treatment plans.
Learn more about our empathy-driven program for Medicare.