Healthcare News of Note: Significant social risk is just one reason some consumers struggle with healthcare

• Addressing unmet social needs may be necessary but not sufficient to remove barriers to receiving healthcare for consumers with significant social risk.
• Interventions aimed at improving vaccine confidence among some physicians may be needed so that all physicians can fulfill their vital role as trusted vaccine communicators.
• The gap in life expectancy between the United States and peer countries has widened to more than five years.

Over the last few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 

1. Specific social factors are not the main reasons people with significant social risk fail to get all their needed healthcare, says McKinsey & Company

“Though respondents with significant social risk were more likely to report not getting all needed healthcare, eight of the 10 most common reasons for not getting all needed care were not related to specific social factors,” according to a Feb. 20 article by McKinsey & Company.

“Instead, they were related to affordability, healthcare access, health literacy, and low expectations of the healthcare system,” the authors wrote. “This suggests that addressing unmet social needs may be necessary but not sufficient to remove barriers to receiving healthcare for consumers with significant social risk.”

For this point, McKinsey relied on analysis from its 2019 consumer surveys conducted to determine “access and satisfaction” among Medicare beneficiaries, Medicaid beneficiaries, the Medicaid churn population and those with dual Medicare and Medicaid coverage.

Top reasons for not getting their healthcare needs met

The top reasons those with significant social risk gave for not getting the healthcare they needed were:

1. Cost to get care was too high
2. Care was not covered by insurance
3. Not motivated to get care
4. Could not get care due to lack of transportation
5. Did not think preventative care was needed
6. Care was unavailable (e.g., could not get an appointment)
7. Worried PCP could not help with issue
8. Inconvenience of getting care
9. Unable to leave work
10. Unable to find appropriate care provider

What can be done to improve healthcare utilization?

Addressing social needs nonetheless can play a role in  improving patients’ healthcare utilization and outcomes. The article authors suggest that:

• Providers tailor a patient’s care plan and follow-up to the patient’s social context, and partner with local community organizations to provide social services where needed
• Payers incorporate data about social needs into existing analytics and systems to better equip care managers and customer care teams in supporting members

2. A troubling proportion of U.S. primary care physicians lacks high levels of vaccine confidence, study says

“Interventions aimed at improving vaccine confidence among some physicians may be needed so that all physicians can fulfill needed roles as trusted vaccine communicators,” was the conclusion drawn by authors of an April 20 study published in the journal Vaccine.

“Identifying appropriate interventions is an important direction for future research and could include improving virology and vaccine biology education in medical school or echoing existing approaches for the general public by identifying trusted individuals in physicians’ lives to improve their confidence in vaccines,” added the authors.

Study highlights

Study outcomes show that “a troubling proportion of primary care physicians lack high levels of vaccine confidence,” wrote the study authors. “These physicians may not be well positioned to actively promote COVID-19 vaccination even as political and media narratives push physicians to lead this effort.”

Study highlights include:

• 10.1% of primary care physicians do not agree vaccines are safe.
• 9.3% do not agree vaccines are effective.
• 8.3% do not agree that vaccines are important.
• Physician confidence in COVID-19 vaccines varies across vaccines (68.7% and 72.7% of primary care physicians were very confident in the safety of the Moderna and Pfizer vaccines, respectively, while only 32.1% of physicians were very confident in the safety of the Johnson & Johnson vaccine as of May 2021).

3. New study: The gap in life expectancy between the United States and peer countries widens

“The U.S. mortality experience during 2020 and 2021 was more severe than in peer [other high-income] countries, deepening a US disadvantage in health and survival that has been building for decades,” according to an article in medRXiv, a preprint server for clinical research. 

The United States saw a net loss of 2.26 years, from 78.86 years in 2019 to 76.99 in 2020 and 76.60 in 2021, according to the authors. During this time period, “US Hispanic and non-Hispanic Black populations experienced the largest losses in life expectancy,” the authors wrote.

“In contrast, peer countries averaged a smaller decrease in life expectancy between 2019 and 2020 (0.57 years) and a 0.28-year increase between 2020 and 2021, widening the gap in life expectancy between the United States and peer countries to more than five years,” the authors wrote.

U.S. and peer-country mortality data for 2019-21 were obtained from the National Center for Health Statistics, the Human Mortality Database and overseas statistical agencies.

HFMA bonus content

Read the April 19 article “Medicare’s proposed increase for inpatient payments in FY23 doesn’t meet hospitals’ expectations” by Nick Hut, senior editor.

Register for HFMA’s Annual Conference to be held June 26-29 in Denver.