Rocky Mountain Health Plan Finds Connection Between Social Isolation, Loneliness and SDOH

We all are alone sometimes, but social isolation and loneliness (SIL) are serious mental health concerns that can present serious challenges. The National Institutes of Health defines loneliness as the distressing feeling of being alone or separated. Social isolation is having few people to interact with regularly. Social isolation and loneliness have both been linked to poor health outcomes.

A new screening tool, developed by the Centers for Medicare & Medicaid Services (CMS), has revealed that SIL are predictive of other social determinants of health (SDOH) including housing instability, food insecurity, transportation issues, utility help needs and interpersonal safety. The risk of each SDOH was 200% to 750% greater for individuals experiencing social isolation and loneliness compared with the general population.

The data came from 50,000 members of the Rocky Mountain Health Plan who were dually eligible. Members were given the Accountable Health Communities Health-Related Social Needs Screening Tool at participating clinics between October 2018 and March 2022.

Of the unduplicated individuals screened, 14% appeared to be experiencing social isolation and/or loneliness. Individuals experiencing SIL were 1700% more likely to also screen positive for interpersonal violence-related needs.  

The screening tool is an evidence-based approach that identifies gaps and promotes collaboration among clinical care and community services to address the needs of patients. The Rocky Mountain Health Plan was able to administer the screening tool through a pilot program funded from an Accountable Health Communities Model through the Center for Medicare & Medicaid Innovation.

Most respondents in this group were young, low-income, working-age adults with a low socioeconomic status. A majority of these individuals were also BIPOC.

Using the information learned from the screening pilot with the Rocky Mountain Health Plan, health care professionals have started creating multi-impact treatment plans that holistically address both social isolation and loneliness as well as other SDOH needs.

Read the complete findings and learn more about how the plan is using the findings to address patients’ social needs, improve health outcomes, reduce costs and create higher satisfaction.

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