Managing chronic conditions in healthcare deserts: strategies for health plans
Healthcare deserts impact millions of Americans, limiting access to necessary care and worsening chronic conditions. Explore the evolution of this issue and learn how health plans can employ strategies that improve patient outcomes and lower costs.
Understanding healthcare deserts
What are healthcare deserts — and where are they located?
More than 60 million people live in healthcare deserts — geographical areas with limited or no access to essential healthcare services. For people living in these areas, finding timely and adequate healthcare can seem like an uphill battle. Healthcare deserts can also complicate benefits management for health plans by reducing in-network options for members and driving up overall health costs.
While healthcare deserts are common in rural regions, they can also be found in any area where the healthcare needs of its residents are unmet due to a shortage of healthcare providers, facilities, and pharmacies; long wait times for an appointment; unreasonably high costs; or other factors related to social drivers of health.
Why healthcare deserts matter for people with chronic conditions
Regardless of the setting, healthcare deserts can be especially problematic for individuals living with chronic conditions who require increasing levels of medical care. For these individuals, scarce healthcare resources can ultimately lead to lower treatment adherence, poor health outcomes, and higher costs.
Advances in medical science, data, and technology have generated promising new ways to mitigate the challenges posed by healthcare deserts. When aligned strategically, these advancements can be leveraged to help health plans offer access to whole-person care that improves patient health and lowers costs.
How healthcare deserts impact chronic conditions
Chronic conditions such as cancer, heart disease, diabetes, or mental illness affect more than 120 million Americans . An estimated 42% of them manage two or more complex illnesses.
According to the Centers for Medicare & Medicaid Services, the situation is even more complicated for seniors, with two-thirds of Medicare recipients living with multiple chronic conditions. Healthcare deserts can worsen the plight of these individuals by increasing the likelihood they will experience:
- Delayed or foregone care. When it is difficult to find and access healthcare nearby, individuals may put off or skip necessary treatment.
- Long waits for an appointment. Since early intervention is often key to managing chronic illness, appointment delays can lead to less successful treatment outcomes.
- Travel-related stress. Patients often experience added emotional stress when they must travel long distances for medical care. For those with serious health conditions, the journey itself can be exhausting and demoralizing.
- High costs related to social drivers of health. Traveling to receive medical care can be costly. Additional expenses such as transportation costs, childcare, and loss of income due to missed work can even extend to family members who may have to take time off to help. The added economic strain can discourage people from getting the care they need, especially when they lack transportation options or family support.
- Cultural and linguistic barriers. Cultural differences between providers and patients can lead to misunderstandings, misdiagnoses, poor treatment adherence, and a general lack of trust in the healthcare system.
Strategies to address healthcare deserts
Addressing healthcare deserts requires a comprehensive strategy that provides more options for people with chronic conditions and the health plans that help them manage those conditions. Advances in technology, data, and clinical practice provide health plans with new solutions that advance equitable access to treatment, improve patient outcomes, and lower costs.
Telehealth solutions
Telehealth is a transformative tool that can significantly increase access to healthcare. The COVID-19 pandemic led to a surge in telehealth across many specialties, particularly in behavioral health. Telehealth is a powerful solution for continuous care regardless of geographical constraints.
By utilizing both synchronous and asynchronous telehealth methods, members can receive care at any time of the day or night. Audio-only visits and text-based self-navigated tools help eliminate digital constraints for people lacking digital literacy or high-speed internet and computers, making healthcare more accessible.
Telehealth can be especially helpful for people who have impaired mobility due to physical limitations or chronic pain . Members living with complex health conditions can benefit from receiving treatment in the comfort of their homes.
Support for primary care providers
“Greater support for primary care physicians (PCPs) can significantly strengthen a health plan’s network and create more options for patients,” said Dr. Hossam Mahmoud, Medical Director for Carelon Behavioral Health. Strategies such as the collaborative care model and electronic consults enable them to manage both physical and behavioral health conditions more effectively. Paired with investments in infrastructure, support through care coordination, and engagement with patients, these added support measures help ensure continuous patient care.
Developing value-based partnerships with pharmacies
Pharmacies are crucial for community health, offering convenient and immediate services. In addition to medication dispensing, many pharmacies also provide convenient access to vaccines and primary care support. As Lisa Morris, Chief Clinical Officer for CarelonRx , states, “A lack of nearby pharmacies can have profound effects on both patients and health plans. Without access to pharmacy care, health issues are more likely to go unaddressed and the possibility of hospitalization increases.”
Additionally, Morris points out, “Limited pharmacy services can drive up costs. Without pharmacies to close gaps in care, patients may require more intensive and expensive treatments down the line. This is costly for both members and their health plans.”
Establishing value-based partnerships with high-performing and independent community pharmacies can help close these gaps, improve patient health, and lower healthcare expenses by ensuring access to essential medications and treatments for those with chronic conditions.
Better access to healthcare benefits everyone
Health plans can increase access to treatment, improve patient outcomes, and lower costs by taking a multifaceted approach to addressing healthcare deserts. Methods such as telehealth solutions and robust support systems for primary care providers can be combined to ensure whole-person care for individuals living with chronic and complex health conditions.
