Healthcare News of Note: Community health workers can influence better use of healthcare providers among certain populations

• Community health workers communicated with Medicaid beneficiaries to develop a plan for their health and connect them with social and healthcare services in their local area, according to a university study.
• Nearly 1 in 10 adults, or 23 million people in the United States, owe significant medical debt, according to a data analysis.
• Generation Z is more likely to report having a behavioral-health diagnosis but less likely to report seeking treatment compared with other generations.

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

1. Contact with community health workers could help some people rely less on the ED and more on outpatient care, a new study shows

“Community health workers [CHWs] employed by Medicaid health plans can help low-income people who face barriers to care rely less on the emergency room [ED], and more on outpatient care, a new study finds,” according to an April 1 article in ScienceDaily.

The study, conducted by the University of Michigan Institute for Healthcare Policy and Innovation in partnership with local and state organizations and agencies, was published March 24 in the American Journal of Public Health.

“The CHWs in the study worked with Medicaid participants to make a plan for their health and connect them with social and health care services in their local area,” the article authors wrote.

Study highlights

According to ScienceDaily, by the end of the first year:

• The 284 people who had contact with a CHW had an average of 6.4 medical office visits and 2.8 ED visits per person-year.
• The control group, composed of 1,400 that might have been contacted by a CHW, had 5.3 medical office visits and 3.1 ED visits per person-year.
• The group of 1,100 people who were chosen to participate but had no CHW contact had 4.8 medical office visits and 3 ED visits per person-year.
• Emergency care costs per person-year were about $500 less for the active group of 284 than for the control group, and outpatient costs were about $450 more.

The ScienceDaily article quoted Michele Heisler, MD, MPA, who led the project and is a professor of internal medicine at the U-M Medical School: “These results are really heartening, especially through the lens of success for Medicaid plans of decreasing acute care use and increasing use of ambulatory care among individuals who have not been accessing primary care.”

2. 23 million people in the United States owe significant medical debt

Nearly 1 in 10 adults, or 23 million people, in the United States owe “significant medical debt,” which analysts defined as more than $250, according to a Peterson-KFF brief published March 10.

The authors analyzed Survey of Income and Program Participation (SIPP) data “at the individual level for adults who reported owing over $250 in unpaid medical bills as of December 2019.”

Additional survey data, according to the authors, indicates:

• People in the United States owe at least $195 billion in medical debt.
• Approximately 16 million people, or 6% of adults, owe over $1,000 in medical debt.
• About 3 million people, or 1% of adults, owe medical debt of more than $10,000.
• People with disabilities, those in worse health and poor or near-poor adults are more likely to owe significant medical debt.
• Black Americans (16%, compared to 9% of white and 4% of Asian Americans) and people living in the South (12%) or in Medicaid non-expansion states (12%) were more likely to have significant medical debt.

“Unsurprisingly, middle-aged adults are more likely than young adults to have significant medical debt,” wrote the authors. “However, the share of adults with significant medical debt decreases when people reach Medicare age. We find that 12% of adults ages 50 to 64 report having significant medical debt, compared to 6% for those ages 65 to 79.”

3. McKinsey analysis: Gen Z reports least-positive life outlook and lower levels of emotional and social well-being than other generations

“Gen Z [reported] the least positive life outlook, including lower levels of emotional and social well-being than older generations,” state the authors of a McKinsey & Company article published in January. 

According to additional study findings based on consumer surveys and interviews conducted by McKinsey, Gen Z respondents were:

• More likely to report having been diagnosed with a behavioral-health condition (for example, mental-health or substance-use disorder) than either Gen Xers or baby boomers
• Two to three times more likely than other generations to report thinking about, planning or attempting suicide in the 12-month period spanning late 2019 to late 2020
• More likely to report having a behavioral-health diagnosis but less likely to report seeking treatment compared with other generations

What does it mean for healthcare providers?

“When they do seek support for behavioral-health issues, Gen Z may not be turning to regular outpatient mental-health services and instead may rely on emergency care, social media, and digital tools,” wrote the study authors.

“Gen Zers rely on acute sites of care more often than older generations, with Gen Z respondents one to four times more likely to report using the ER, and two to three times more likely to report using crisis services or behavioral-health urgent care in the past 12 months,” the authors added.

HFMA Bonus Content

• HFMA members can access all of the content in the April issue of hfm magazine.
• Register for HFMA’s Annual Conference to be held June 26-29 in Denver.   
• Read the top 5 takeaways from HFMA’s Revenue Cycle Conference, written by Paul Barr, senior editor.