LTSS (Long-term service and support) and SDOH (social determinants of health) are closely intertwined for people in the Medicaid population, especially when considering the era of COVID and social isolation. As you can imagine, community integration and support, such as access to food, housing, and transportation, are essential components of a healthy life and living to one’s best capacity. Without transportation access, quality housing, and sustainable nutrition, normal life becomes out of reach, worsening social isolation and health outcomes. AMA PERS just may be the silver bullet that Managed Care is looking for when trying to pierce the threshold and break through to new heights of Wellness Management, especially when considering the impending and growing lack of quality caregivers.

Social Determinants of Health

What are social determinants of health?

Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-lif outcomes and risks.

SDOH can be grouped into 5 domains:

Economic Stability

Education Access and Quality

Health Care Access and Quality

Neighborhood and Built Environment

Social and Community Context

The Financial Alignment Initiative, funded by  Centers for Medicare and Medicaid Services, tested, in partnership with states, integrated care and financing models for Medicare-Medicaid enrollees. The state demonstrations under the Financial Alignment Initiative were specifically developed to coordinate care across the two separate Medicare and Medicaid systems and to address the complex needs of dually eligible individuals, including health and health-related social needs. The cat is out of the bag,  the test is over, and  this is where the industry is going. Every major player’s hat has been in the ring and is jockeying to be best in class.

 

 Here is one glaring, industry wide problem: it became noticeably more difficult to find qualified caregivers during the COVID-19 pandemic, but this current shortage pales in comparison to the looming caregiver crisis facing America over the next several years.

 

It is pretty simple. The baby boomer population is the number one reason behind the increasing lack of good caregivers to meet the needs of the elderly. Approximately 10,000 baby boomers enter our markets every day. Our senior population is expected to double in the next 20 years, swelling to close to 90 million by 2050. Within the aging population, about 70% of individuals have a need for LTSS services, often for multiple chronic health conditions, including mental decline.

 

Additionally, an overwhelming number of seniors are receiving care in their home setting rather than in an institution. According to the AARP, almost 80% of adults ages 50 and older prefer to stay in their homes as they age. Also, we need to be mindful of the efforts by the already strained healthcare system to keep sick seniors out of hospitals, assisted living facilities, and nursing homes and instead have them cared for in their homes.

 

Unfortunately, it is unlikely that the adult children of our clients will be able to participate at the levels they want to, as they struggle with the challenges they face.

 

Clients in the lower income brackets will be, of course, the hardest hit. How will this shortage impact social determinants of health for the dually-eligible population specifically?

 

The combination of these demographic realities and care delivery wants, needs, and in some cases, having no other alternative,  has led to the current spike in demand for caregivers. At the same time, however, the home-based care industry is experiencing a workforce shortage. Reports by the Global Coalition on Aging and Home Instead Senior Care examined the current state of the caregiving workforce. They predict that a national shortage of 150,000 plus caregivers will exist by 2030 and a greater than 350,000 caregiver shortfall by 2040.

 

Alert Medical Alarms is at the forefront of cutting edge innovation when it comes to solving real-time concerns for MCOs trying to achieve positive yet cost

effective outcomes for their participants in the surge of the looming caregiver shortage crisis. We are simply there when caregivers may not be.

 

AMA PERS can assist members with everything:

Physical, mental, and emotional challenges.

All four of these areas critically impact a client’s SDOH.

Health effects of social isolation and loneliness

High blood pressure, heart disease, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death are all increased by social isolation and loneliness. Social isolation significantly increases a client’s risk of premature death from all causes. Loneliness rivals health risk factors as much as physical inactivity, smoking, and even obesity. Here is why:

The latest data suggests that immigrant populations experience loneliness more often than other groups. Fewer social ties and a lack of social integration are key factors. Immigrants also experience stressors that can increase their social isolation. Let’s consider the differences in community and family dynamics, coupled with new relationships that lack depth or nostalgic connection. Keep in mind that our monitoring center provides services in over 100 different languages. This will become increasingly important in order to communicate.

 

As we continue to age, there are inevitable losses we all face. Loved ones and friends move on or pass away. Society changes and neighborhoods shift. This can cause seniors to feel sad or depressed. They simply miss the loved ones who have now moved on or passed away. It’s HARD…

Over 60% are living in low-income communities

Dementia deaths have increased by 16% during Covid

11.3% of people over the age of 60 are faced with Dementia

Alert Medical Alarms is at the forefront of cutting edge innovation when it comes to solving real-time concerns for MCOs trying to achieve positive yet cost

effective outcomes for their participants in the surge of the looming caregiver shortage crisis. We are simply there when caregivers may not be.

 

AMA PERS can assist members with everything:

Physical, mental, and emotional challenges.

All four of these areas critically impact a client’s SDOH.

Introducing the AMA elopement and wandering solution

Overview :

A family member or friend is able to send an SMS message to the PERS device that their participant is wearing. Once the text is sent, the device will reply with its exact GPS location using Google Maps.

How It Works :

If you have a client in this category,

Bed Exit Alarm Set:

In Home Door Alarm Sensors:

Let us help keep your clients safe.

Elderly Maltreatment What You Need To Know

At least 10% of adults age 65 and older will experience some form of elder abuse in a given year, with some older adults simultaneously experiencing more than one type of abuse.

Abuse can happen anywhere, especially in our clients’ homes. The mistreatment of older adults can be done by family members, neighbors, health care providers, caregivers, or friends.

Types of Abuse

There are many types of abuse:

Abuse can happen to any older adult, but often affects those on managed care who depend on others for help with activities of everyday life, including bathing, dressing, and taking medicine. People who are frail are easy victims.

 

Even if our clients have 24-hour care, an AMA PERS device is both the ultimate intervention and prevention of abuse. Help is just a button push away. A non-response button push will immediately deploy emergency services

AMA PERS gives power back to the abused and more:

AMA PERS reduces the impact of falls and puts managed care ahead of social isolation and maltreatment concerns through our Dispatch Reporting Process.

 

Have your members been admitted to the hospital without you knowing? Avoid the frustration of a client not telling you about an incident; our cutting-edge PERS solutions provide detailed real-time communication that keeps you in the loop for any critical incident or trigger event.

Every time one of your members pushes their button, here’s what happens:

Our trained operators assess the situation and quickly dispatch the right help.

If a trigger event or critical incident has occurred, we send real-time email notifications directly to the service coordinator including the details of the incident.

We follow-up with our clients directly to make sure their lives are back on track and to ensure their needs are met.

IN CONCLUSION

When considering the minimal cost of AMA PERS coverage, Alert Medical Alarms’ entire process and functionality helps states leverage managed care in the pursuit of improving the social determinants of health for all members, which is essential to ensuring eligible individuals enjoy the greatest balance of safety, health, freedom and independence.