Healthcare News of Note: 45% of consumers have at least 1 health-related social need

• Consumers across socioeconomic levels and insurance types report having health-related social needs, which suggests programs could be designed to meet the needs of a variety of consumer segments.
• Medicare Advantage enrollees have over 70% fewer hospital readmissions and 25% fewer preventable inpatient admissions than those enrolled in Medicare fee-for-service plans.
• In 2022, 48.7 million people ages 12 or older in the United States reported having a substance use disorder in the past year.

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

1. 45% of consumers surveyed have at least 1 health-related social need, says McKinsey & Company

Forty-five percent of consumers report experiencing at least one health-related social need (HRSN), such as food insecurity, child-care needs or social support, on a regular basis, according to a McKinsey & Company article published Nov. 14. An additional report further explores the issue of food security in the United States, and another looks at how these disparities contribute to “worse health outcomes” for children.

Call to action

These unmet HRSNs affect health systems and hospitals “as consumers with two or more unmet HRSNs are three times more likely to report visiting the emergency room ‘frequently’ than those reporting having no unmet HRSNs,” wrote the McKinsey authors.

Among the HRSNs listed below, the most prevalent were reported by nearly a third of those surveyed. Those include: “childcare (among those with children), material status (the ability to pay for utilities or purchase basic goods), and social support (feeling lonely, not having someone to count on or missing having someone to talk to).”

“Health insurance companies, health systems, employers, and others could consider a range of actions to address” consumers’ HRSNs, which include childcare, material status, social support, food security, community safety, employment, transportation, housing, education and personal safety, wrote the authors.

Additional results

Other survey results, based on findings from a 150-question online poll of 5,010 U.S. consumers conducted by McKinsey in 2022, include:

• Most of those reporting HRSNs have more than one unmet need.
• Consumers across socioeconomic levels and insurance types report having HRSNs, “suggesting programs could be designed to meet the needs of a variety of consumer segments.”
• Consumers with HRSNs were more likely to report poor physical and mental health and barriers to accessing care.
• Consumers with multiple HRSNs were more likely than other groups to report seeking support from family or friends, yet roughly 20% do not seek support.

U.S. food insecurity

According to a report by the U. S. Department of Agriculture (USDA) Food and Nutrition Service, nearly 13% of households in the U.S. were food-insecure for at least some time during 2022, including 5.1% with very low food security.

“Very low food security is the more severe range of food insecurity where one or more household members experienced reduced food intake and disrupted eating patterns at times during the year because of limited money and other resources for obtaining food,” wrote the authors.

Key findings

Other findings about food security during 2022, according to the USDA report, included:

• 87.2% of U.S. households were food-secure throughout the entire year, with access always to enough food “for an active, healthy life.”
• The number of food-insecure households was “statistically significantly higher,” at 12.8%, compared with 10.2% in 2021 and 10.5% in 2020.
• The number of U.S. households with very low food security was also “statistically significantly higher,” compared with 3.8% in 2021 and 3.9% in 2020.

Worse health outcomes for children

According to a study of 10,504 children as reported in JAMA Pediatrics on Oct. 16, children living in high socioeconomic deprivation had the worst health outcomes, “including more mental health issues, suicidal behaviors, lower cognitive performance, and poor physical health,” relative to children living in three other types of environments (affluent communities, high-stigma environments, and environments characterized by factors such as high crime and drug sales).

Additional observations from this study showed:

• High socioeconomic deprivation areas are characterized by the highest rates in most metrics of the Area Deprivation Index (e.g., family income, income disparity, low home value, unemployment rates, high poverty rates, high single-family proportion, no telephone), the Social Vulnerability Index (e.g., poverty rates) and Child Opportunity Index (e.g., lowest health insurance), according to the authors.
• Better mental health, cognitive and physical health outcomes were attributed to children living in affluent areas.
• Lower cognitive performance (cognitive intelligence, reasoning scores), higher BMI and more sleep disorders were experienced by children residing in high-stigma environments, such as mobile homes and group quarters, or in an area with industrial pollutants, ozone, heat exposure, low population density and lowest walkability; and by the group of children who live in areas characterized by higher crime rates and drug sales, lower education attainment and higher population density.

2. MA plans have lower overall utilization than FFS, says Harvard-Inovalon study

The latest Harvard-Inovalon Medicare study builds on findings from a previous white paper, which indicated that Medicare Advantage (MA) had lower overall utilization than fee-for-service (FFS) and that the lower utilization was driven by fewer inpatient visits.

“Specifically, MA enrollees have over 70% fewer hospital readmissions and 25% fewer preventable inpatient admissions,” wrote the authors in the new study. “At the same time, we find that MA exhibits lower rates of inappropriate medication use, and comparable rates of medication adherence.”

“The study underscores the role that care management and coordination can play in promoting quality within the Medicare program,” wrote the authors.

Insight for health plans and policymakers

“This work is intended to support health plans and policymakers through valuable analytics and new insights,” added the authors.

“This study and related analytics can help plans understand their own quality outcomes, and how they compare to those of peers, particularly after adjusting for underlying characteristics of the health plan’s members.”

For policymakers, the study “sheds new light on the quality improvements that MA delivers for beneficiaries, relative to FFS.”

3. 9.4 million more marijuana users in the United States in 2022 than 2021

In 2022, marijuana remained the most-used illicit drug, with 22%, or 61.9 million people, among those ages 12 or older using it in the past year, according to a Nov. 13 report by the U.S. Department of Health and Human Services (HHS) through the Substance Abuse and Mental Health Services Administration (SAMHSA). In 2021, SAMSHA’s reported figures were 18.7%, or 52.5 million people.

Marijuana use by age group

By age group, the number of people using marijuana in the past year was:

• 18 to 25: 38.2% or 13.3 million people, in 2022, compared with 35.4%, or 11.8 million people, in 2021
• 26 or older: 20.6%, or 45.7 million people, in 2022, compared with 17.2%, or 37.9 million people, in 2021
• 12 to 17: 11.5%, or 2.9 million people, in 2022, compared with 10.5%, or 2.7 million people, in 2021

Other illicit drug use

Among the other 2022 data available in the latest SAMSHA report:

• 48.7 million people ages 12 or older (17.3%) had a substance use disorder in the past year, including 29.5 million who had an alcohol use disorder (AUD), 27.2 million who had a drug use disorder (DUD), and 8 million people who had both an AUD and a DUD.
• 8.9 million people ages 12 or older (3.2%) misused opioids (heroin or prescription pain relievers) in the past year.
• 991,000 people ages 12 or older (0.4%) misused prescription fentanyl or used illegally made fentanyl (IMF) in the past year, including 686,000 people (0.2%) who used IMF in the past year.

HFMA bonus content

• Read the November issue of hfm magazine, including the From the Chair column “Are states losing patience with the pace of healthcare value transformation?” by HFMA National Chair Dennis E. Dahlen, and the Voice of Experience column “Theresa Mouton: CFOs need to be able to lead through chaos,” by Steven Berger, FHFMA.
• Listen to the Nov. 20 Voices in Healthcare Finance podcast episode “Improving health outcomes while combating homelessness,” where Beth Sandor of Community Solutions speaks with podcast host Erika Grotto about a pilot program in which health systems partnered with organizations in their communities to fight homelessness.  
• Read “Congress doesn’t seem to be mulling a fix for the 2024 Medicare physician payment cut,” by Nick Hut, senior editor.