JUNE 28 - JULY 2, 2020  
30 years of Care Transitions Across the Full Continuum

PP202 – Behavioral Health Managed Care and Reduction of Social Determinant of Health Barriers

PP202 – Behavioral Health Managed Care and Reduction of Social Determinant of Health Barriers

Due to the growing amount of data linking poor health outcomes directly to social determinants of health, social factors are an increasingly vital component of our approach to care management. Our current initiative strives to increase access to care, services, and the resources necessary for preventative health and successful recovery. New Directions can positively influence social, environmental, and economic conditions that support changes in individual behavior by taking a population health-based approach to care management at a community and neighborhood level and connecting members to community support resources, thus supporting a preventive healthcare model and improving overall health and well-being. Our strategies go beyond the provider office and into the community with the development of multiple modalities in care, such as Field based services (CM and peer support), Telephonic CM SDOH screening, Z code analysis, and CM/PCP support.

Through the development of a Resource Access Portal (RAP), we proactively analyze our patients’ communities with facilities/resources overlaying their demographics to understand existing linkages between their social services infrastructure.  While elimination of barriers through referral is key, we recognize that some SDOH such as environmental conditions, may be difficult to impact, but believe they should be considered when identifying appropriate treatment or healthcare providers and community services, referring for specialized or trauma informed care as appropriate.

We support members by educating on health risks related to SDOH and facilitate routine health screenings and compensatory lifestyle choices and behaviors when risk factors are identified.  By providing individuals and families with the tools and resources they need and empowering them to take some necessary steps, we believe health outcomes will improve and that data related to current initiatives will support that.