ChenMed’s Colleen Mourra featured on Better Medicare Alliance Study

Innovative Approaches to Addressing Social Determinants of Health for Medicare Advantage Beneficiaries

ChenMed’s Colleen Mourra, Associate Director of Population Health Management, contributed to the Better Medicare Alliance’s study, “Innovative Approaches to Addressing Social Determinants of Health for Medicare Advantage Beneficiaries.” This study focuses on how Medicare Advantage addresses social determinants of health (SDOH) that influence health outcomes.

…There is also evidence that some leading-edge providers are seeing value in the use of Z codes, with ChenMed reporting that it is preparing an internal effort to encourage thorough Z code documentation including enterprise-wide use of a standard assessment tool and, more importantly, a documented care plan for social needs…

…“When you add a code to a problem list, you have to address that code. We hold our teams very accountable for that. You must address the need. And in the past, it was always, ‘How can I address it? I'm a doctor. I'm not a social worker.’” -Colleen Mourra, Associate Director of Population Health Management, ChenMed…

…Providers reported having to dedicate staff to figure out which conditions were associated with each plan's particular set of benefits. “Depending on what specific plan a patient is enrolled in, they may have [SDOH-related services] as a benefit. But that is always so hard to decipher. First of all, does the plan even have a program available? If your patient is lucky enough to be enrolled in a plan that has a needed benefit, the next step is to figure out what the eligibility criteria for them to take advantage of that benefit. Do they qualify? What do they need to sign up? Is there a deadline or timeframe?” said ChenMed’s Colleen Mourra. “So if you don't have a team dedicated to this, and if your patients don't have the ability to navigate the system on their own, if a benefit is there, very often it's unused, which is very sad.”…

Click here to read the full study.