Care silos have long been a headache for the health care industry. Fragmentation and interoperability across care providers fuels inefficiencies and redundancies, and decreases the chances for timely interventions at heavy financial and operational costs, not to mention poorer outcomes.
This fragmentation has particularly severe consequences for the Medicaid population, who for a whole host of reasons often struggle to navigate the health care system and advocate for themselves, often resulting in patients slipping through the cracks or receiving care only after a condition has become acute, and more challenging and costly to manage.
Here's four ways payers and providers could be using digital health to improve care for these vulnerable populations.
Helps identify risk
In the maternal health space, women who receive no prenatal care or care later in their pregnancy are more likely to experience a premature delivery or C-section. Complications such as hypertension or gestational diabetes are more difficult to manage with late identification and can contribute to increased maternal morbidity and mortality.
To begin to solve some of the structural difficulties of care coordination, innovators are developing solutions that connect payer and provider: platforms where everyone can be on the same page about the care and needs of the member/patient.
For example, through surveys and assessments delivered digitally, a member can be identified as at-risk. Technology can then act as a facilitator between payer and provider, ensuring that the member is immediately connected to resources, the care team (provider, case management, and payer team) is notified, and that all stakeholders are informed about what is happening.
Enables mental health intervention and management
Risks like depression and suicidal thoughts, domestic abuse, and substance addiction are particularly pertinent problems in our pandemic environment, as the already high instances of such events have been exacerbated by quarantine restrictions, lockdowns, and a struggling economy.
COVID has increased anxiety, particularly in pregnant women who are already prone to it. This takes a harder toll on minorities, especially African American women who are already struggling with structural racism in our country. A strategy for identifying and managing these risks is crucial for making sure these women do not slip through the cracks.
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Creates empowered patients
Digital education and remote monitoring tools can empower patients and members throughout the pregnancy so that they understand what they're experiencing and can put a name to it, helping them advocate for themselves in their health care system.
This is particularly important for minority women, who often feel intimidated and not taken seriously by the system. If patients are given access to a blood pressure (BP) monitor, for example, they can speak more accurately about their condition, assigning a data point to the symptoms they're experiencing. They can then communicate the emergency of their condition in clear terms to their provider, and receive the appropriate response.
Increases attendance and compliance to care plan
A remote monitoring solution can also capture data from patients who may be no-shows at appointments, a massive problem for women on Medicaid. Remote patient monitoring opens access to care for these patients, and it also opens appointments for the provider team to be able to treat the most acute patients.
As the landscape of care moves to a blended model of virtual and in-person, it is more important than ever that payers and providers take responsibility for Medicaid populations and ensure that they don't get lost in the shift.
Juan Pablo Segura is an active voice in advocating to improve access to innovative models of care for the underserved. He is a board member of Heathtech4Medicaid and a frequent speaker on the subject of digital health for Medicaid and low-income populations. In 2014 he co-founded Babyscripts, a virtual maternity care company delivering a new model for prenatal and postpartum care that is transforming the way expectant mothers use technology to work with their healthcare providers.
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