How We Help

Health Equity

Helping members who routinely don’t get access, ReferWell gets them scheduled for the care they need.

Only 10 to 20% of a member’s health outcomes are attributable to medical care. Conversely, as much as 70% of health is determined by non-medical fac- tors such as behavior and the social and physical environment. These social determinants of health (SDoH) factors play such an important role that it is critical that health plans help members gain access to non-medical care.

Coupled with that, some members need extra support to navigate the healthcare system. Those who face social and physical barriers need even more help finding and scheduling care. Data shows that when payers provide help in scheduling member appointments with community-based organizations, mental health counselors and other agencies, they directly impact outcomes.

This whole-person approach to navigating access to care is moving the needle for all, but especially the most vulnerable populations who are starting at a deficit to the rest of the member population.

Preventive care scheduling to reduce disparities

100%

member outreach by care navigators

50%

impact in high ADI zones

56%

member engagement in conversation

25%

members scheduled for appointments

> Read the case study

Medicare and Medicaid plans are advancing health equity by enabling timely access to care and simplifying appointment scheduling for member populations that disproportionately face barriers to achieving their best health outcomes.

> Listen to Equity and Timely Access as a Stars Strategy, an episode of the Bright Spots in Healthcare podcast.

A Digital Health Solution Advancing Health Equity and Providing Timely Access to Care

Robust Provider Directories

A good directory is not simply a clean list of providers or agencies who have contracted with the health plan. It is a robust database of searchable information that supports advancing health equity — such as the languages spoken in provider practices. When health plans make it easier for members to communicate with doctors in their preferred language, members understand their care plans and have better outcomes.

Care Includes SDoH Referrals

Plans that broaden the definition of care are addressing health disparities faster. Care must include access to not just medical appointments, but also the additional services that address the barriers to equitable healthcare, such as transportation assistance, nutritional counseling and easy access to mental health or other behavioral health services to name a few.

Appointment Scheduling That Delights

Innovative plans do not simply make these social services available; they’re putting health equity into action by helping members get scheduled and go. Care navigators reach out to beneficiaries and find them the Perfect Match^SM, removing the burden of searching for doctors and agencies and getting them to appointments faster and get engaged in a care plan that suits their unique needs.

Care navigator discusses empathy in health equity

Empathy in Health Equity & Access

Jada Creer, ReferWell care navigator, talks about building trust and the role of empathy in her team’s member outreach.

> Hear from Jada

A Member Experience to Support Health Equity

The Common Member Experience Today
(the Member’s Perspective)

My provider tells me about the specialist or SDoH agencies available and pressures me to schedule a visit with them. I may or may not reach out, and sometimes I can’t reach or don’t hear back from the practice to set up a visit.

The Innovation
(Again, the Member’s Perspective)

A care navigator calls me and shares a list of qualified providers or SDoH agencies. I choose the time/date/location/gender/language that is right for me. I get automated reminders that help ensure I don’t miss the appointment.

> Read more about health equity trends on the blog

A Member Experience to Support Health Equity

A large plan partnered with ReferWell to increase member satisfaction and improve CAHPS scores for Medicare and dual-eligible members by proactively scheduling Annual Wellness Visits.

The plan achieved an impact rate of 25% overall and up to 50% in the most disadvantaged zip codes. Fill out the form to the right to see how.