An advocate for navigating social health barriers

After a serious fall, Gayle* was having a hard time taking care of herself and had to move in with a family member who lived in a rural area. Limited mobility and a lack of transportation left her struggling to find the right resources to help manage her day-to-day health needs, including a way to get access to the prescriptions she needed.

Gayle’s story is an example of the fact that 80% of a person's health is determined outside a doctor's office. Things like stable housing and access to food and transportation can have a profound effect on a person’s overall well-being. That’s why they’re also known as social determinants of health.

Gayle was struggling to manage her care needs and didn’t know where to turn. That’s when she met Corinne Crabtree, an Advocate4Me senior health care advocate with UnitedHealthcare. Corinne’s job is to help answer questions and make connections for people like Gayle.

UnitedHealthcare advocates have a wide range of qualifications, from nursing degrees to experience resolving highly complex health care claims issues. They also have access to a full team of clinicians, pharmacists and other members of the care team, so they can draw on many experts to help find solutions.

In Gayle’s case, Corinne started by finding a care professional in her new community. The next challenge was physically getting Gayle to the doctor’s office for an initial visit that was required before she could transition to virtual care.

“Gayle didn’t have transportation, so I needed to find some way to get her there,” Corinne said. “I was not letting this go without doing everything I possibly could to make sure Gayle was able to get to the doctor and get the medicine she desperately needed. Her life depended on it.”

Corinne used a new capability within the UnitedHealthcare Advocate4Me program designed to help members who may be struggling to find community-based resources, including things like transportation help.

Advocate4Me uses predictive analytics from de-identified claims and other data to help identify members who may have barriers to care — and to connect them to services for support.

A recent enhancement to this capability enables more than 16 million members enrolled in employer-sponsored health benefit plans to log into their account and access a curated database of low- or no-cost community resources, including ones that may offer access to things like nutritious food, affordable housing or internet access.

When eligible members like Gayle call for support, advocates like Corrine listen for phrases like “I lost my home” or “I don’t have a car” to help find appropriate resources. However, advocates also know that it’s not always easy for members to share when they’re struggling with basic needs like food and transportation. That’s when powerful technology and insights can help create a proactive experience.

Advocate4Me predictive personalization tools can:

  • Automatically route callers to an advocate whose skills and training match the needs
  • Helps advocates quickly understand why the member is calling — sometimes before they even speak
  • Bring up health opportunities before members even ask about them

Advocates can then provide a personal, compassionate and simplified experience to help members navigate the health care system. Ultimately, this improved member experience may lead to lower costs and better health.

Through Advocate4Me resources, Corinne found a non-emergency ground transportation program that helps people like Gayle who lack dependable ride options.

“I checked back and confirmed that she did get to the doctor and was able to get the medicine she needed,” Corinne said. “That is what makes me love my job — helping people live longer, healthier lives.”

Learn more about Advocate4Me.

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