Many family caregivers and physicians caring for older adults experience difficulties managing the day-to-day non-clinical aspects of care such as access to food, safe housing, and transportation. Physicians and other healthcare professionals have few options when trying to address these social determinants of health (SDOH). Consequently, family caregivers are often left to deal with these stressful needs on their own, leaving physicians in the dark about the social and environmental factors responsible for 60-80% of health outcomes.
The NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for Medicare Special Needs Plans (SNPs). HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance. Each Medicare Advantage plan is rated out of 5 stars. The rating is determined based on many factors such as customer service, getting needed prescription drugs, rating of drug plan, care coordination, and rating of healthcare quality. Losing a star in a Medicare Advantage plan rating can pose serious financial implications.
As the NCQA increases its focus on SDOH to address the needs stated above, they have proposed a new HEDIS measure (SNS-E). This measure would evaluate screening of members for unmet food, housing, and transportation needs, as well as whether an intervention was implemented for identified needs. The measure would include the following domains:
CaringWire is a digital platform used on the web or a mobile device that engages caregivers to screen for unmet food, housing, transportation, and other SDOH needs, complying with the new HEDIS measure. After needs are identified, CaringWire guides caregivers to better “understand” and improve their situation by offering personalized bite-sized recommendations. These recommendations (of education and services) help address SDOH needs while promoting healthier and safer practices. CaringWire also offers healthcare professionals useful SDOH insights to support better outcomes. These insights are shared with clinicians and other stakeholders on an aggregated dashboard built for their patient population.
CaringWire enriches lives and unlocks potential for health plans, health systems, and providers. When using CaringWire’s SDOH screening capabilities, Medicare Advantage plans become less vulnerable to losing star ratings due to the SNS-E measure. Maintaining these star ratings is vital to the financial success of the Medicare Advantage plan.
The benefits of CaringWire’s SDOH screening extend to family caregivers, physicians, and patients themselves. Once the screening is completed, caregivers will receive actionable guidance to address physical, environmental, and social needs. Since the SDOH are just as important as clinical aspects of health, giving the caregivers access to the information they need leads to higher levels of confidence and reduced stress. The benefits for caregivers can be seen not only with satisfaction, but with improved service utilization, goal setting, and coordination of care. They become key stakeholders in overall care delivery when actively engaging with the CaringWire platform.
Physicians benefit because CaringWire is an excellent evidence-based addition to existing treatment strategies for medically complex patients. When clinicians are made aware of physical, environmental, and social needs, care delivery and treatment become more personalized. CaringWire enables physicians to extend clinical capabilities and enhance population health management.
When patients spend their time in hospitals instead of the comfort of their homes, they are not only prone to anxiety, but also significant financial consequences. CaringWire aims to reduce unnecessary hospital visitations and improve each patient’s overall health status by meeting previously unidentified SDOH needs.
At CaringWire, customer service is the top priority. Our team works “quickly, professionally and creatively,” according to our partners. We are ROI minded, and constantly work to improve our products to fit the specific needs of each customer. To learn more about our products and services, email us at solutions@caringwire.com or call at +1 614-271-1792.
