Study: WellCare’s Community Assistance Line Coordinates Social Care

Pamme

Pruitt

A call center-based social support role may be a valuable addition to the evolving healthcare workforce, according to a new study.

The study published in The American Journal of Accountable Care shows how a community-assistance line successfully leveraged the life experiences of its trained operators to handle patient calls and provide social support and empathy to callers who were experiencing stressful life circumstances.

The Community Assistance Line is a toll-free, nationwide call line available to both WellCare members and the general public. The line launched in 2014 with six associates, and today, has grown to a team of 50. The diverse team includes operators ages 18 to 70 who leverage their own personal experiences with social services to assist callers. Operators include reserve and retired members of the military, students, individuals with disabilities, and caregivers.

The year-long study was conducted by the University of South Florida (USF) College of Public Health and WellCare, a provider of government-sponsored managed care services. It examined how “CommUnity Liaisons” address the social needs of callers helping them connect with financial, housing, transportation, and other resources, while often providing emotional support.

Study findings

The results of the study, the first in a series that WellCare and the USF College of Public Health is currently conducting, are intended to help managed care executives identify better ways of delivering improved health outcomes to beneficiaries who often have challenges in life that go beyond healthcare, and reduce unnecessary healthcare services using tools that address social determinants of health. 

Specifically, the study found:

• CommUnity Liaisons perform a unique function in the effort to integrate social and medical care. People often contact the call center due to a social crisis in their life, not necessarily because of a medical need.
• Because of personal life experiences, some CommUnity Liaisons can better link a caller’s need to the more than 160,000 community-based social services in WellCare’s database.
• As peers with similar lived experiences, CommUnity Liaisons can empathize with a caller’s stressful life experience, which improves the integration of social and medical care.

“CommUnity Liaisons, a new peer-support person role, can effectively use their own personal experiences to assist callers experiencing a range of stressful life circumstances and connect them to social service supports,” says lead study author Zac Pruitt, PhD, USF College of Public Health, Department of Health Policy and Management. “These CommUnity Liaisons provide a unique perspective having ‘lived’ the experiences of many callers. For example, they may have been on Medicaid or Medicare or experienced disability, homelessness, or other life challenges and can offer peer-level support.”

The most common social service referrals included: patient and family support (25%); transportation (20%), and housing assistance (18%).

“The study offers support that an integrated, holistic approach to care can help beneficiaries receive the unique services they need to improve their overall health,” says author Pamme Taylor, MBA, vice president, WellCare’s Center for CommUnity Impact.

Estimates show social factors including healthy food, safe housing, and financial security account for nearly 70% of all health outcomes. The study found that call center representatives provide social support in stressful circumstances that may not warrant the services of a doctor, nurse, or medical social worker.

“By addressing social barriers to health, managed care organizations can help address the root cause of many health issues and avoid unnecessary costs, while delivering higher-quality care,” Taylor says.

Since it launched in 2014, WellCare has built a repository of more than 160,000 social services and community-based programs, and CommUnity Liaisons field about 8,500 calls a month.

"At WellCare, we've found that when compared to similar members, those individuals with social barriers removed were at least two times more likely to be compliant with primary care visits, six times more likely to improve BMI, and nearly two times more likely to comply with diabetes-related treatments,” Taylor says.

“While healthcare providers may lack the time or inclination to invest in programs that address social barriers health, managed care organizations possess a strong incentive to create new and innovative ways to lower costs and improve health outcomes for their members,” Pruitt says. “As managed care plans look to address the social determinants of health, they should understand that addressing these barriers requires attention both to the needs of the member as well as the ability to build community-based social service network capacity. This study examined one effective way to identify and remove social barriers.”

Future research will examine how health plans can maximize social service delivery system capacity, according to Pruitt.