Giving Compass' Take:

• MedCity News reports on the importance of healthcare organizations not just to find those who need chronic care management, but to engage with them at the point of contact to build trust.

• Are health orgs too reliant on baseline measurements, neglecting the more holistic aspects of good care? How can we integrate data tools in a smarter way to help people in this area?

• Read more about the behavioral interventions we can use to improve healthcare.

Eighty percent of members’ health is determined by social factors such as housing, economic position, education and social connections, so called social determinants of health. But, most healthcare organizations struggle to use social determinants data to target members for focused intervention, a recent study found.

Even when payers and providers have access to a range of data that can point to the need for targeted social support interventions, they face challenges in effectively engaging members and providers in these support services that improve health and health outcomes.

Some members who would benefit from care management to address chronic conditions at their earliest stages are difficult to locate. They may face lack of stable housing, for example, which can contribute to high levels of stress, impaired coping and weakened social connections.

But all too often, the challenge of locating and engaging members who would benefit from care management interventions is as much about gaining trust and acceptance of assistance as it is about pinpointing their location. When care managers fail to engage members at the first point of contact, the risk that members will avoid future interactions with care managers significantly increases. In the face of identified care gaps, with each avoided phone call, the likelihood of successfully lowering a member’s risk for experiencing a medical event is decreased.

Read the full article about designing a high-value approach to chronic care management by Virginia Gurley at MedCity News.