Identifying & Addressing Socioeconomic Barriers to Care throughout the Member Lifecycle

Thursday, December 8, 2016 - 1:00pm

Too often, socioeconomic barriers fall outside the benefit structure of health plans. How can effective care be delivered when we ignore life factors impacting members? It is critical for healthcare organizations to direct efforts and resources towards addressing issues of social inequities, diagnose problems and remove barriers that negatively impact the health status and quality of life of their members. Eliza can play an important role in identifying these barriers to care and connecting high-risk members to plan resources such as medical, behavioral and social care management.

In a recent Eliza program addressing the social determinants of health for health plan members:

  • 40% of respondents reported having some difficulty getting to the doctor’s office.
  • 35% of respondents were concerned about cost.

People who report concerns about life necessities were five times more likely to report poor health than good health.

People with self-reported ‘life problems’ also reported that their health negatively impacts their work functioning by nearly 2.5 more times than those without life problems.

Similarly, people reporting concerns for life necessities were eight times more likely to report high emotional stress.

Early screening, identification, and effective interventions are key to minimizing barriers to care, creates a partnership with individuals that improves health, promotes brand loyalty and provides long-term ROI for the health plan.

This webinar will discuss strategies to help assess and address social determinants of health in order to promote the health and wellness of health plan members. Eliza does this by having a direct and open dialogue with members, with the intention of better understanding individual needs and barriers to care, and connecting members to valuable plan and community resources. This webinar will focus on the following elements necessary to address social determinants of health:

  • Communicate: Augment traditional data gathering techniques such as the use of live agents or in person interviews with automated, multi-channel, digital technologies such as telephonic IVR and email
  • Collect: Deploy standardized and validated survey tools such as a vulnerability assessment that can help identify issues without having to ask members in-person
  • Compare: Establish benchmarks for your member population and compare results using a common ruler
  • Connect: Once barriers to care are identified, connect members to plan and community services, such as health coaching, care management, housing assistance, or transportation services to support health outcomes.

Eliza will share recently-collected insights from Medicaid, Dual and Marketplace populations, including:

When working with the Marketplace population in the South, over 23% of respondents were concerned about “life necessities,” such as having a place to live, access to food and/or feeling safe. Individuals between the ages of 35 and 50 were 5% more likely to be concerned about these things.

  • Over 56% of Medicaid members in the Northeast who responded that they were very concerned about “life necessities,” also reported physical problems greatly impacted their ability to work and/or take care of others.



Betsy Mazzoni
Manager of Quality Improvement
Gateway Health 

Betsy is responsible for inspiring a team of innovators who design strategies aimed at improving HEDIS scores, health outcomes, and member engagement. A relative newcomer to the managed care industry, she brings over 10 years of experience in health care and human services. Betsy joined Gateway Health from Bethany Hospice, where she held an executive role focused on operational excellence. Prior to working in health care, she held a variety of public policy roles in local and state government and in the nonprofit sector serving children residing in substitute care and adults with serious and persistent mental illness. Betsy holds a Master of Public Administration and a Master of Social Work from the University at Albany in Albany, New York and a Bachelor of Arts in Psychology from Bard College in Annandale-on-Hudson, New York.


Aimee Delorey, PhD
Senior Director, Data Science and Analytics
Eliza Corporation

Aimee has spent nearly 20 years in analytics, consulting and business development roles serving health plans, biotechnology and pharmaceutical companies. Her areas of expertise and interest include health outcomes, psycho-social influences on health and risk assessment. At Eliza, Aimee manages a team of data scientists and leads analytic efforts in several areas, including Social Determinants of Health.

Aimee graduated from Goucher College with degrees in English and Sociology, and earned her PhD in Social Science from Boston College.



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