GoHealth Examines Role of Medicare Advantage Supplemental Benefits in Addressing Seniors' Social Determinants of Health Disparities

Rhea-AI Summary

GoHealth examines the impact of Social Determinants of Health (SDOH) on Medicare Advantage (MA) plans. Nearly 80 percent of health outcomes are influenced by factors like economic stability and education. Despite significant interest—43 percent of at-risk members wanting transportation services—actual usage remains low, indicating a gap in benefit utilization. GoHealth aims to empower seniors through digital tools and health literacy initiatives to enhance access to MA benefits, ultimately improving physical, mental health, and overall well-being.

Positive

• GoHealth's focus on addressing SDOH could lead to improved health outcomes for MA members.
• 43% of at-risk members are interested in supplemental benefits, indicating potential growth in service utilization.

Negative

• Actual utilization of supplemental benefits is significantly lower than expressed interest.
• Challenges remain in engaging MA members to utilize their benefits effectively.

CHICAGO, April 22, 2021 /PRNewswire/ -- GoHealth, Inc. (GoHealth) (NASDAQ: GOCO), a leading health insurance marketplace and Medicare-focused digital health company, examines how risk factors outside the scope of traditional healthcare can be mitigated through supplemental benefits offered by Medicare Advantage (MA) plans. These extra benefits—such as free meal delivery, transportation to and from appointments, and even community connections—are underutilized by MA beneficiaries, despite their efficacy in addressing some of seniors' greatest health risk factors.  

These risk factors are known as Social Determinants of Health (SDOH), and they can affect up to 80 percent of an individual's overall health outcome and include elements such as education level, neighborhood and physical environment, and economic stability, among others. At the population health level, however, it can be difficult to screen and engage MA members in preventative care addressing SDOH issues, resulting in avoidable health issues and poorer quality of life for these MA members, coupled with increased costs across the entire healthcare system. The failure to consider and address SDOH issues is especially prevalent among marginalized communities, where multiple factors prevent our neediest populations from accessing the right care, in the right setting, with the right provider, at the right time.

Supplemental benefits offered by MA plans can help address SDOH issues and keep members healthy. However, SDOH-focused benefit utilization lags behind member interest, even in instances where these benefits are included in an MA plan. For example, while GoHealth research found that 43% of our most at-risk members are interested in transportation services as an extra benefit and 25% expressed interest in a fitness benefit, actual utilization of these benefits is much lower than this expressed interest. In order to drive better utilization among MA members, the benefits must fit into the daily lives of seniors. "Features" like telehealth visits, home modifications, and pet services sound great, but must tie to health outcomes and find their way to seniors in order to be useful. Furthermore, ensuring the availability of supplemental benefits is only one piece of the equation. The next step is to ensure the member is aware of—and is encouraged to use—these benefits.

Read more: Addressing Social Determinants of Health for Seniors

"It is important for all of us, from health plans to providers and beyond, to help increase access to care for everyone in our communities," said Paul Hain, M.D., Chief Medical Officer at GoHealth. "With full utilization of their plan benefits, including those targeted toward SDOH issues, seniors can see improved outcomes in many areas, including physical and mental health, as well as general well-being."

Ensuring Benefit Utilization

GoHealth is committed to serving as a trusted advisor to seniors, helping them navigate the healthcare ecosystem and understand the benefits included in their MA plan. We empower underserved seniors through our TeleCare and Low Income Subsidy (LIS) teams while offering health literacy and digital tools to improve access to care. GoHealth is proud to align itself with the mission of addressing social disparities within determinants of health.

About GoHealth, Inc.:

As a leading health insurance marketplace and Medicare-focused digital health company, GoHealth's mission is to improve access to healthcare in America. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science and deep industry expertise to match customers with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare and individual and family plans. For more information, visit https://www.gohealth.com.

Contacts:

Investor Relations, IR@gohealth.com
Media Relations, pressinquiries@gohealth.com

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SOURCE GoHealth, Inc.

FAQ

What is GoHealth's recent focus in the Medicare Advantage space?

GoHealth is examining how supplemental benefits in Medicare Advantage plans can mitigate the impact of Social Determinants of Health on seniors.

What percentage of health outcomes is influenced by Social Determinants of Health?

80 percent of health outcomes are impacted by Social Determinants of Health.

What specific benefits are Medicare Advantage members interested in?

43% of GoHealth's at-risk members are interested in transportation services, while 25% are interested in fitness benefits.

What steps is GoHealth taking to improve benefit utilization?

GoHealth is empowering seniors with digital tools and health literacy initiatives to enhance awareness and usage of their Medicare Advantage benefits.