Inflation Takes a Toll on Social Determinants of Health.

The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

By: Philip Middleton, Vice President of Social Determinants of Health

It’s no secret that inflation has been rough for all of us, but it’s hit those on low and fixed incomes the hardest. As prices rise for food, housing, energy and more, the most vulnerable are forced to make dangerous tradeoffs that negatively impact their health and well-being. They might skip meals, go without air conditioning or heat, skip doctor’s appointments or cut their prescriptions in half. All these lifestyle and environmental factors are what we call Social Determinants of Health (SDoH) and can affect our health and quality of life outcomes.

As a compassionate company, ilumed wants to help Medicare patients with dignity and respect while empowering them to partner with their physician. We believe when everyone can achieve their full health potential, we will have achieved true health equity. One way we’re doing that is by addressing barriers that prevent care and, ultimately, drive health disparities. When we help Medicare patients get the food and transportation they need to maintain their health, we’re helping them combat inflation.

SDoH barriers are common

According to the U.S. Census Bureau, 9% of Americans aged 65 and older experience poverty. Across all age groups, Hispanics have a poverty rate of 17% and Blacks have a poverty rate of 19.5%. The stats on SDOH are equally as sobering:

  • 5.2 million seniors (6.8% or 1 in 15) experienced food insecurity in 2020 according to Feeding America.
  • A joint survey by Evidation and Lyft Healthcare found that 31% of Medicare and Medicaid beneficiaries missed provider appointments or ran out of medicine because they could not access transportation.
  • Low-income Medicare beneficiaries are more likely to rent, making them more vulnerable to price increases, overcrowding, moving frequently and spending a higher portion of their income on housing.

Why SDoH barriers are so dangerous

Let’s say you are diagnosed with a disease that has a 95% survival rate. You might think your odds are pretty good to beat it, but that’s only true if you can get to your treatments. What if you have mobility challenges or must rely on rides from others or public transportation? Getting to your appointments becomes more difficult. Think about how challenging it can be to travel in inclement weather. Wet or slick sidewalks pose fall hazards. A missed bus ride effectively means a missed appointment, which can lead to worsening health outcomes and, in the end, the chances of disease survival decreases. These situations can be mitigated or altogether avoided with the right type of support—the kind of support ilumed fosters.

How rising costs are hurting Medicare beneficiaries

According to a survey by the Senior Citizens League, half of people aged 55 years and older have dipped into their emergency savings to deal with rising costs. Here’s where rising costs are hitting hardest:

  • Rents continue to skyrocket and are up by 10% or more in some areas year over year.
  • A typical mortgage payment is 76% higher today than it was in June 2019.
  • Food costs are up on average 13.1% due to inflation as well as an avian flu, severe drought and the war in Ukraine. Here’s how the price increases rate per item:
    • Eggs: 38%
    • Flour: 22.7%
    • Chicken: 17.6%
    • Milk: 15.6%
    • Ground beef: 9.7%
    • Fruits and vegetables: 9.3%
    • Bacon: 9.2%
  • Public transportation costs can account for as much as 1–2% of a person’s income.

Even with increased Social Security benefits or Supplemental Nutritional Assistance Program (SNAP) benefits, many on Medicare are forced to do with less or cut necessities. In 2023, the average Social Security check is expected to increase to $1,656 per month yet monthly food costs range from $245–411 for some aged 51–70. Those dollar amounts add up to 15–25% of someone’s monthly Social Security check, which is 5–15% more than the average American spends on food as a portion of their income.

At ilumed, we’ve witnessed many patients have their purchasing power gutted. SNAP benefits previously helped them get three weeks’ worth of groceries and now they’re lucky if they can get two weeks’ worth. To make matters worse, many food companies are charging more for smaller portions, a phenomenon known as shrinkflation, which leaves consumers with less food for the same cost.

In addition, these patients may be using their benefits to help support other family members like grandchildren. And now those grandchildren are going without enough food too. This creates a generational domino effect that’s heart wrenching, unacceptable and continues to erode population health outcomes.

Get to know our pilot food insecurity program

Let’s take food insecurity as an example of how we’re giving patients a hand up rather than a handout. Food is nutrition, and nutrition is health. If someone has diabetes or a heart condition, their diet will impact how they respond to their care plan. We know that helping patients get the nutrition they need is vital to their overall health and well-being. That’s why we developed a pilot program to help the most vulnerable patients get reliable access to food while we also help them find long-term community-based solutions. We help providers identify patients with food insecurity or lack of transportation, get them into the pilot and help them receive the care they need and deserve.

Our pilot provides two meals a day for seven days a week to qualifying patients, delivered straight to their door. They get heat-and-eat meals, pantry staples and/or fresh produce. This program helps reduce financial burdens related to inflation while supporting a healthy diet. Our efforts focus first on getting to know our patients and understanding their challenges. We then create a plan that offers personalized solutions to meet both their acute and long-term needs with a combination of internal and external resources. We then measure results to reduce unplanned hospital and emergency room admissions, decreasing the number of days between primary care visits and increasing engagement with ilumed case management for care coordination and education. We believe this level of engagement enhances the patient/primary care provider relationship and leads to better health outcomes.   

In addition to this program, we compiled a list of community-based resources in each of the communities we serve. If someone struggles with social isolation, loneliness or housing insecurity as well as food insecurity, we can connect them to local resources. We’re not burdening the provider staff with this work but are instead providing turnkey solutions that are quick and easy to implement. In this way, we’re helping to elevate population health one community at a time. We see our work as a true partnership between ilumed, providers and patients. This isn’t just “another program,” it’s a game changer.

Making our work count

As a kid, I was taught to love my neighbor. Tackling SDoH with ilumed, helps me do just that. Bringing SDoH into the spotlight helps us connect people to the resources they need and deserve, which helps us drive down the cost of care by avoiding unnecessary emergency room visits. When that happens, we all win, because we get to see our loved ones and neighbors live their best lives. When everyone has equal access to care and the ability to achieve their full health potential regardless of their social position, that’s when we’ll have achieved true health equity.

Think you’re ready to team up with ilumed and help your patients overcome SDOH? Get in touch here. Together, we can heal healthcare.

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