Addressing Medical, Behavioral and Socioeconomic Conditions to Improve Health Outcomes
There are so many elements that make up who we are as people — our biology and genetics, our behavioral and personality traits, the environment in which we live — the list goes on. Whether we realize it or not, these characteristics have a considerable impact on our physical and emotional wellbeing, but they have historically been absent from the conversation about healthcare.
Trends toward personalized medicine and value-based care are changing the paradigm, with the idea of treating the whole person emerging as a means to deliver higher quality, more comprehensive care. The philosophy involves equally assessing medical, behavioral, social and economic conditions to develop a treatment plan that addresses all of the factors influencing a person’s health.
Behavioral, Physical and Social Determinants of Health
Segregating physical health from behavioral health has helped to fuel a historically fragmented system — a phenomenon exacerbated by neglecting to also consider social determinants of health (SDoH) in patient care.
Most people understand, on some level, what maintaining a healthy lifestyle entails — eating the right foods, being physically active and avoiding harmful habits like drug and alcohol abuse.
Treating the whole person means taking into consideration the underlying factors that can inhibit a person’s ability to practice healthy habits so that healthcare professionals can address the root of the issue and not just the symptoms.
Integrating Behavioral Health
If left untreated, mental illness can become a catalyst for serious physical health issues. Even if the physical condition is not a direct result of the mental condition, secondary factors like substance abuse can equally lead to chronic, often life-threatening physical disease.
For many who suffer from mental illness, repeat doctors’ visits and misdiagnoses are all-too- common occurrences. For example, a patient complaining of digestive issues might be sent to a gastroenterologist for a series of tests and prescribed medication based on the best hypothesis. But that patient might also be suffering from an anxiety disorder, of which stomachaches are a symptom. Similarly, a patient with high blood pressure may be prescribed an antihypertensive, when anxiety and depression could be underlying factors.
Neglecting to consider the full range of physical and behavioral conditions impacting a person’s health causes widespread inefficiencies that drive up healthcare costs and lead to poor health outcomes.
Physical & Social Determinants
Physical environment (i.e., where a person lives, works or spends a considerable amount of time), is one example of a nonclinical risk factor that, if left unaddressed, can become detrimental to health.
Poor housing conditions, for example, may increase a person’s risk of exposure to toxins like lead and asbestos. With this knowledge, the healthcare provider has the context to be able to determine a more accurate diagnosis and effective care plan. And the healthcare payer can intervene by connecting the member with information and resources to help minimize the risk of exposure-related disease.
Social determinants are things like income status, availability of basic resources or any other socioeconomic condition that could inhibit a person’s ability to access care and maintain healthy habits.
Each year, an estimated 3.6 million people in the US miss non-emergency medical care due to transportation issues. With access to data on factors like income level and geographical location — and the channels to reach and engage high-risk members — payers can take action to help ensure a lack of transportation does not impede access to care.
How Do We Treat the Whole Person?
To treat the whole person, payers and providers must work together to understand and address the various clinical and nonclinical factors that can determine health outcomes.
In a true personalized care environment, treatments are tailored to the needs of the patient, creating less fragmented, more effective care at both the individual and institutional levels. More personalized care means:
- More effective treatment plans
- Less overmedicalization
- Increased member and patient satisfaction
- Enhanced efficiency and cost savings for members, patients and the healthcare system as a whole
- Long-term improvements in quality of care and, in turn, health outcomes
Value-based models emphasizing a coordinated care approach are helping to eliminate healthcare silos and unite resources to better serve patients and members. When teams of providers with a diverse range of experience work together, they are able to design a comprehensive care plan that fully addresses the needs of the patient — medical, behavioral and socioeconomic.
The Role of Data and Technology in Patient-Centric Care
Integration is key to realizing the full potential of personalized care in improving health outcomes. Payers, providers and even patients must be able to communicate seamlessly to understand the full range of contributing health factors and pursue treatment plans that are effective in the long-term. Analytics and engagement tools are helping to unite all healthcare stakeholders around the needs of the member and patient, and are vital to facilitating higher-quality, higher-value care.
By focusing on the underlying causes of illness, the industry can begin to shift away from fragmented, one-off treatment methods and toward a more holistic model wherein people are empowered with the information, resources and care to live healthier overall.