It can be challenging to ensure members of your population have quality healthcare when you’re working with Medicaid recipients. These individuals are often part of a vulnerable population, with diverse needs when it comes to health management but limited resources and sometimes low health literacy.
For their part, health plans must put forth their best efforts to give health risk assessments (HRAs) to every Medicaid member within 90 days of enrollment—and with good reason. (Read a summary of the CMS’ final rule here – this link opens as PDF.) An HRA can be an invaluable tool as you work with individuals to improve their health. The results of an HRA can be used not only for insights into this population’s health risks, but can inform targeted, personalized interventions and wellness initiatives.
In this post, we’re taking a look at how HRAs can improve Medicaid population health.
How Do HRAs Improve Population Health?
We’ve discussed before that HRAs are useful in informing wellness initiatives and in some states are considered a critical component in establishing provider-patient relationships, goal setting, and collaboration. When they’re reviewed collectively over time, HRA results can identify trends to address. In turn, knowing the issues that individuals are facing can help determine the resources and interventions that will be most effective in improving health outcomes.
And it may not always be something directly related to providing more medical care. For example, HRAs may indicate that there are community-wide issues, such as a higher-than-normal smoking rate or poor access to healthy foods that could lead to cardiovascular issues down the road.
By reviewing assessment results, you’ll be able to gain insight into these issues as well as which types of resources or interventions are needed. If you’re seeing that most people are eating an unbalanced diet, you could put together a brochure of community options, such as food pantries. Similarly, if it seems that many people aren’t getting the daily recommended amount of exercise, you could work with a local fitness or recreation center to promote free programs or subsidized memberships. These small steps could have a large impact as individuals begin to take charge of their health, potentially decreasing the need for costly medical treatment by warding off chronic conditions.
Conquer Hesitation Head-on
When working with vulnerable communities, it’s important to address hesitations and concerns up front. Some common hesitations include:
- Wanting to put off hearing “bad news,” or not putting their health first.
- Wondering what good an HRA will do if they don’t have resources to address identified risks.
- Having limitations in completing the HRA in the first place (either at home or at their practitioner’s office) due to health literacy or other barriers.
By letting your Medicaid population know the benefits of taking an HRA, you can increase the likelihood that they’ll participate. Therefore, it’s important to inform them of the benefits of completing the assessment and work with them to provide assistance when possible.
For those individuals who are concerned that their results will deliver bad news, you can let them know that an HRA is not a diagnostic tool. Their results will provide them with information related to their current health and lifestyle status that could put them at risk for illness down the line—illnesses that can be addressed or entirely prevented with early action.
Another thing that should be made clear is that their HRA can do more than simply tell them their risks. The next step in the process is to look at various resources and interventions that may be available. They should be made aware of any community resources or government programs that they qualify for such as:
- Free vaccination clinics,
- Food pantries, and
- Preventive services that Medicaid covers at either full-cost or with low-copays such as routine doctors’ visits and lab work.
It may not be feasible for some to make sweeping adjustments to their lifestyle. If they’re shift workers taking care of young children, they may not be able to clock a full eight-hours of sleep. Or if they’re on a tight budget with limited access to fresh groceries, changing their diet significantly may be a hardship.
But by laying out the importance of these changes in respect to their current health risk, working with them to set attainable goals to make improvements, and providing information on available local resources providers can make a strong case for these adjustments and help along the way.
At the end of the day, regardless of what type of population you’re serving, an HRA can be a valuable tool in providing care and implementing wellness initiatives. And choosing the right HRA is crucial to the success of your plan. Learn more about increasing Medicaid engagement in our newest guide, 5 Strategies to use HRA data and increase Medicaid engagement.
