Programs go Beyond Health in Pursuit of Wellness


By Heather Caspi


WellCare Health Plans, Inc. is among those testing the waters of wellness initiatives that go outside the box of healthcare.

Its ‘Ohana Health Plan will offer free GED testing to its eligible Medicaid members beginning Jan. 1, 2016, in an effort to address overall well-being. The organization isn’t alone in its way of thinking.

‘Ohana Health Plan

“Education is one of the social factors that researchers agree is linked to longer, healthier lives,” WellCare spokesperson Heather Urquides told Healthcare Dive.

As a provider of government-sponsored healthcare, Wellcare serves a high proportion of members with low incomes and complex medical needs, she says. “Helping our members obtain GED certificates can lead to higher paying jobs and increased health literacy, which means they can make more informed decisions about their health, the health of their families, and better understand and adhere to treatment plans.”

WellCare first offered the GED benefit to Georgia members in 2012. Seeing it received significant interest, Wellcare expanded the benefit to Kentucky and Illinois in 2014. Hawaii is its most recent expansion. The company is considering adding the benefit in other states as well.

WellCare is a strong believer in looking beyond health, particularly for members facing greater challenges and barriers to care.

“Our approach to helping address the social determinants of health go beyond our health plan benefits,” Urquides says. Those efforts include WellCare’s HealthConnections Model, which supports existing social service organizations in their communities through micro-grants and other strategies and aims to identify gaps in social services and work with community stakeholders to address them.

The company also points toward its launch this year of a toll-free community assistance line (CAL), which is open to the public and helps connect people to social service programs across the U.S.

Urquides notes research supports their approach. A study by the Robert Wood Johnson Foundation and the University of Wisconsin School of Public Health found 80% of what determines health is unrelated to direct care delivery, she says.

“We know that people cannot prioritize their health when their basic social needs are not being met,” adds Pamme Taylor, WellCare’s vice president for advocacy and community-based programs. “By simply helping people to address these needs, WellCare expects three positive outcomes: People will lead better, healthier lives; there will be greater support for the social safety net; and the overall costs of healthcare will be reduced.”


Such a view is an appropriate and competitive step toward the future, suggests Jonathan Dugas, director of clinical development for the Vitality Institute, a global research organization aimed at identifying evidence about what works for health promotion and disease prevention.

Some of the areas where they’re seeing interest are in financial health wellness, workplace design, and the community element to workforce health, Dugas says.

“We can go much further than simple incentives of paying people to do a few healthy things,” he says.

The Vitality Institute is looking at how to use the wellness structure they’ve built to bring in these additional elements. In the case of community health, for example, that can mean helping a large employer connect with its community to address environmental and social drivers of workforce health at a higher level. The institute released a report this year that demonstrates this relationship and shows some industries tend to be concentrated in areas with poor health, and provides strategies for addressing community and workforce health.

With competition in the wellness space growing, “it’s the innovators who are going to come out on top,” Dugas says.


To view original article, click here.

Thumbnail Credit: Fotolia via Healthcare DRIVE

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