RISE looks at recent headlines concerning social determinants of health (SDoH).

New Commonwealth Fund study underscores mental health disparities among seniors

Adults over the age of 65 in the United States are most likely to report a mental health condition diagnosis than older adults in other high-income countries, according to a recent comparison from The Commonwealth Fund (Commonwealth). For the comparison, Commonwealth looked at the mental health needs and access to care of older adults in the U.S. and 10 other high-income countries.

Key findings from the analysis include:

  • One in five U.S. Medicare beneficiaries reported a mental health diagnosis of anxiety, depression, or another mental health condition, compared to five percent of older adults in Germany
  • Among older adults in the U.S., Hispanic/Latinx Medicare beneficiaries are more likely to report a mental health condition compared to white or Black beneficiaries
  • Self-reported emotional distress was commonly reported by older adults in France and Hispanic/Latinx Medicare beneficiaries in the U.S.
  • Mental health needs were most common in older adults in France, the U.S., and New Zealand, with the rate of Hispanic/Latinx Medicare beneficiaries in the U.S. the highest among surveyed countries
  • U.S. Medicare beneficiaries are more likely to seek a health care professional for their mental health needs than older adults in other countries
  • Among older adults with mental health conditions, Medicare beneficiaries in the U.S. are more likely to report cost-related challenges to needed care

In its study of other countries, Commonwealth identified strategies that have been successful in removing financial barriers to mental health care in other countries, including no cost sharing for primary care visits, the elimination of copayments for prescription drugs that treat mental health conditions, a free phone and text messaging service to assess patients’ wellness and provide counseling, and subsidized therapy sessions provided by mental health professionals and general practitioners.

CVS Health and Uber Health announce collaboration to address health equity in vulnerable communities

CVS Health has announced a collaboration with Uber Health to provide free transportation to individuals who need it most to access medical care, work, or educational programs. The collaboration is part of CVS Health’s new Health Zones initiative, which aims to address health disparities in vulnerable communities throughout the country by providing local investments in housing, education, food security, employment, transportation, and health care access.

The RISE Summit on Social Determinants of Health

"We've long known that access to reliable transportation can help address critical gaps in care that often disproportionately affect vulnerable communities. With the past two years of the pandemic only further highlighting today's health inequities, it's more important than ever for communities to have the tools they need to bridge care gaps and achieve better patient and population health outcomes," said Global Head of Uber Health Caitlin Donovan, in the announcement. "Uber Health is proud to be a part of CVS Health's new Health Zones initiative and encourages community organizations to address transportation as a key social determinant of health, while improving health outcomes in a scalable way."

The Health Zones initiative is currently active in five cities, including Atlanta; Columbus, Ohio; Fresno, Calif.; Hartford, Conn.; and Phoenix.. Transportation provided by Uber Health will be available in Atlanta, Columbus, and Hartford. CVS Health and Uber Heath plan to expand their collaboration to additional cities later in the year.

Case study research identifies innovative approaches to address SDoH among MA beneficiaries

NORC at the University of Chicago conducted new research, commissioned by the Better Medicare Alliance Center for Innovation in Medicare Advantage, to explore the initiatives of organizations taking an innovative approach to address SDoH for Medicare Advantage (MA) beneficiaries.

To examine the organizations’ efforts, NORC compiled 13 case studies based on interviews with 12 leading MA plans, provider groups, and community partners, including Aetna, ChenMed, Healthify, Humana, Meals on Wheels America, NowPow, Partners in Care Foundation, SCAN Health Plan, SNP Alliance, SummaCare, UnitedHealth Group, and Unite Us.

NORC focused the case study research on three key areas, including data sources and beneficiary identification, intervention, and evaluation, and compiled best practices implemented by the 12 organizations. The best practices include:

  • Alleviate referral pain points with data analytics for health plans and providers
  • Partner with doctors to share SDoH data and improve the use of Z codes
  • Create an advanced data ecosystem to understand beneficiaries’ needs and promote outreach
  • Assess risk and tailor SDoH interventions to meet needs
  • Partner with vendors to expand supplemental benefits
  • Employ community health workers and/or social workers identify and address SDoH needs
  • Develop a strategy to evaluate the impact of interventions

Survey underscores disparities in telehealth use

While telehealth use increased dramatically amid the COVID-19 pandemic, significant disparities exist among different population subgroups, particularly in terms of audio use versus video use, according to national survey trends published by the Assistant Secretary for Planning and Evaluation (ASPE) Office of Health Policy.

For the survey, researchers used data from the Census Bureau’s Household Pulse Survey from April 2021 to October 2021 to examine respondent’s overall rates of telehealth use, as well as the type of telehealth services used, whether audio-only or video-enabled. The survey found:

  • One in four respondents said they used telehealth services in the previous four weeks
  • While telehealth use rates were similar among demographic subgroups (between 21.1 percent and 26.8 percent), they were significantly lower among uninsured individuals (9.4 percent) and young adults aged 18 to 24 (17.6 percent)
  • The highest rates of telehealth visits were among individuals with Medicaid (29.3 percent) and Medicare (27.4 percent), Black individuals (26.8 percent), and those with an income less than $25,000 (26.7 percent)
  • Among telehealth users, the highest share of visits that used video services were among young adults aged 18 to 24 (72.5 percent), those with an income of at least $100,000 (68.8 percent), those with private insurance (65.9 percent), and white individuals (61.9 percent)
  • Video telehealth use was lowest among those without a high school diploma (38.1 percent), adults aged 65 and older (43.5 percent), and Latino (50.7 percent), Asian (51.3 percent), and Black individuals (53.6 percent)

“The disparities evident in our results suggest new approaches beyond those strategies implemented during the pandemic will be needed to ensure equitable access to telehealth, particularly video-enabled services,” wrote study authors. “For example, considerations for the equitable future use of telehealth as a supplement or replacement for some in-person care need to consider patient-centered outcomes including patient preferences, content of services and frequency of visits, technology access, and quality of care.”