Kaiser Health News reports from the Associated Press, that big players in the health industry are seeing the cost benefits of nabbing problems before they start. That hot lunch delivered to your door? Your health insurer might pick up the tab. The cleaning crew that fixed up your apartment while you recovered from a stroke? The hospital staff helped set that up.
Some insurers are paying for rides to fitness centers and checking in with customers to help ward off loneliness. Hospital networks are hiring more workers to visit people at home and learn about their lives, not just their illnesses.
The health care system is becoming more focused on keeping patients healthy instead of waiting to treat them once they become sick or wind up in the hospital. This isn’t a new concept, but it’s growing. Insurers are expanding what they pay for to confront rising costs, realizing that a person’s health depends mostly on what happens outside a doctor’s visit.
Some of this shift is driven by how health plans pay doctors and other care providers.
For decades, insurers reimbursed mainly for each procedure or service performed, which limits the type of help a doctor can provide. But insurers are shifting more to reimbursement that centers on the patient’s health. That often involves paying providers to coordinate all the help a patient needs to improve their health — and lower health care costs.
Beyond payment changes, insurers and care providers also are stretching their approach to helping patients, especially those with low incomes or chronic conditions.
The Affordable Care Act expanded coverage to millions of people and increased recognition through the health care system that “just giving someone coverage is not going to be enough to ultimately improve health outcomes,” said Samantha Artiga, a Kaiser Family Foundation researcher.
Only about 20 percent of the adjustable factors that determine a person’s health come from care or access to it, according to a 2016 study in the American Journal of Preventive Medicine. Other factors — where a person lives, their income and their diet — combine to play a bigger role.
Delivered meals tailored to a person’s medical condition can help keep patients out of the hospital, according to David Waters, CEO of Boston-based Community Servings, which provides food to people with serious or chronic illnesses. He said patients who are sick, don’t speak English or have little money to buy fresh food often struggle to follow doctor orders on diets.