It’s widely acknowledged that social determinants of health drive medical utilization, health care costs and health outcomes. Research attributes as much as 40% of health outcomes—and up to one-third of deaths—in the U.S. to social factors.

Impact for Health Care Systems

Social determinants of health—socio-economic factors such as physical environment, economic stability, community and social context, education, nutrition, and health care accessibility—can supplement clinical data and offer greater insight into an individual’s risk level, as well as support accurate health care risk prediction and care plan development. When available, review these as part of patient evaluation and care coordination.

Enhanced Health Benefits to Address Factors

In a 2019 United Health Foundation study ranking states by the health of their senior populations, Louisiana ranked 48th with high rates of food insecurity, senior poverty and frequent mental distress in adults ages 65 and older. These social stressors can result in increased risks for chronic conditions, longer hospital stays, higher readmission rates, greater utilization of long-term care and rehabilitation services, and increased mortality rates.

Peoples Health aims to address these challenges by offering the following enhanced health plan benefits:

    • Meals after an inpatient hospital stay are covered for all Peoples Health plan members when discharged to the home or a household in Louisiana from an inpatient hospital stay, inpatient rehabilitation facility stay or long-term acute care facility stay.
    • Respite care sessions are available to most Peoples Health members diagnosed with dementia, depending on the member’s plan. Plan rules for documenting the condition must be met, such as through claim information.
    • Over-the-counter items credit is provided through a prefilled debit card to most Peoples Health members in non-special needs plans, depending on the plan, to buy health and wellness items. Credit amounts vary, and credits are issued quarterly.
    • Food, over-the-counter items and utility bill credit is provided through a prefilled debit card to Peoples Health members in special needs plans, which are designed for those with both Medicare and Medicaid. This benefit offers even greater flexibility through the options to pay for groceries, health and wellness items, and approved utility bills as the member chooses. Credit amounts vary, and credits are issued monthly.

For more information about these benefits, review your 2023 Provider Benefit Packet, contact your Peoples Health representative at 1-800-631-8443, Monday through Friday, from 8 a.m. to 5 p.m., or email phn.provider@peopleshealth.com.