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How Health Plans Can Close Gaps In Care

Posted by Siobhan Bulfin on Dec 12, 2019 12:00:00 PM

Health disparities often prevent patients from getting the medical help they need, resulting in poor health outcomes and increased costs for health plans.If a minority population is more prone to heart disease, any disparities that act as obstacles to health care will likely result in complex chronic conditions that are preventable but end up costing payers more. 


Health plans can take proactive steps to close gaps in care and provide members with the care they need—all while improving their bottom line.

What Are Health Disparities?

Some key health disparities, also known as social determinants of health, are the following:

  • Socioeconomic factors
  • Race and ethnicity
  • Gender, sexual orientation, and identity
  • Disability status
  • Geographic location

Health disparities are also related to genetics. Many of these disparities are out of a member’s control. They are born into a specific set of circumstances and an environment that will affect their future behavior. In the world of medicine, people need to be given equal access to care regardless of their determinants of health.

Why Do Health Disparities Matter?

Access to quality education, nutritious food, safe housing, culturally sensitive health care professionals, decent health insurance, and even something as seemingly simple as clean water and air can have an influence on health. 

Not only do health disparities affect the people with barriers to care—they also limit wider gains in quality of care for the overall population. This leads to unnecessary costs as well. A recent analysis estimated that disparities amount to about $93 billion in excess health care costs and $42 billion in lost productivity each year (not to mention economic losses due to premature deaths). 

The U.S. health care system is serving increasingly diverse populations, making it crucial that these health disparities are addressed appropriately. 

Where Do Health Disparities Stand Today?

Communities and groups across the country are already working on this issue—but it can always be better. Significant progress has been made so far in shrinking the gap in health outcomes. However, countless findings have shown that various populations are still disproportionately impacted by inequity. 

Social determinants of health and health disparities are industry buzzwords, but the fact remains that certain groups are statistically more prone to specific diseases. This seems to be a major reason behind health disparities still. For example, the LGBTQ community is disproportionately affected by AIDS and the African American community is disproportionately affected by heart disease

However, compared to research being done for other segments in health care, health inequities need more research. Partnerships need to be developed as organizations work together to solve these segmented problems.

What Can Health Plans Do to Help Solve Health Disparities?

In this digital age, 96 percent of Americans own cell phones, regardless of ethnicity, age, location, or socioeconomic status. Many own mobile devices beyond that, such as tablets. These mobile tools should be used to provide better access to health care to individuals seeking better care.

Engagement apps developed with accessibility in mind can help activate members in their health by giving them control over their care. They can feel connected and empowered to keep track of the things that will impact their own daily lives regardless of their specific condition, background, or treatment strategies set up by doctors. 

Applications like these can lead to self-awareness and behavior changes because they offer peer support, health coaching, and health tracking. They also provide helpful resources, learning modules, and human connection and support to help people know they are not alone. This technology aims to keep members healthy by influencing them outside the clinical setting and enables them to self-manage. This is especially beneficial for members with chronic conditions.

Self-management is important in patient care, and now it’s made more practical by technology that enables quick, effortless, and accurate insights.

Effectively recruiting and keeping patients can also be done through the right tool. With Melon Health, for instance, health plans can build member loyalty and retention by providing better access to care.

What’s at Stake if We Don’t Work Together to Solve Health Disparities?

Health disparities lead to people falling through the cracks and in need of further costly medical interventions. This results in reduced ROI and a lower bottom line for health plans as they spend more money on more complex conditions. 

Ready to improve member engagement regardless of health disparities? Download our ebook on how to create the right member engagement mobile solution to improve member retention.


Topics: healthcare,, whole person care, value based care

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Why Choose a Digital Platform? 

Whether you are offering the DPP In-Person, Combination, or Online, having a digital platform has many benefits.  A digital platform offers an engaging online community, HIPAA compliant messaging, fitness and nutrition tracking,  an extensive food database, and online modules for make-up sessions.  Increase your participant engagement and maximize your coach efficiency by adding a digital platform to your current DPP Program.  

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