WellCare Offers SDOH Support for Seniors Through End of 2020

WellCare, a subsidiary of Centene Corporation, announced a new partnership lasting through December 2020 that aims to bolster Medicare Advantage the social determinants of health support through better food access for beneficiaries.

“The effects of the pandemic are far-reaching, extending beyond medical care and affecting access to food, medicine, transportation, and more,” explained Michael Polen, Centene's senior vice president and chief executive officer of Medicare Solutions.

WellCare will partner with a delivery service, Shipt, in order to deliver groceries and other daily items to Medicare Advantage members. The partnership will continue through the end of the year.

The app-based service is accessible to low-income and special needs members in WellCare, WellCare TexanPlus, and ‘Ohana Medicare Advantage plans. That demographic encompasses over 200,000 members in 23 states.

The app itself has a consumer base far behind that. Its services are available to more than eight in ten households in 5,000 cities across the country.

“We look forward to offering this new benefit as one more way to simplify access to everyday essentials, ensure continuity of care, and help our members stay safe and healthy during this challenging time,” said Polen.

Seniors’ need for basic resources is clear.

WellCare’s Community Connections Help Line, a toll-free phone service that aimed to serve those in need from March 1 to June 30, 2020, received over 4,000 calls from Medicare members.

These calls centered around requests for basic needs like food assistance. Over a third of the calls were requests for help regarding food instability. Medicare members also called looking for medication assistance and transportation.

Payers have already been adjusting and pivoting their social determinants of health strategies due to the coronavirus pandemic. For example, virtual access to care and telehealth services quickly became a much more urgent social determinant of health as providers and payers delayed non-urgent care.

One way in which payers have had to pivot is by setting social determinants of health programs to last through the end of the year, as WellCare did with this partnership. This is because many experts do not think the US will see a vaccine, and thus the end of the coronavirus pandemic, until at least 2021.

Some pharmaceutical companies are scaling up their manufacturing capabilities and expecting to offer millions of doses by the close of 2021. But that deadline is still a long way off and the vaccine’s efficacy may not be guaranteed. Thus, payers will likely need to continue extending their social determinants of health programs.

Aside from food access, there have been calls to permanently extend telehealth coverage on the federal levels.

“I can’t imagine going back,” CMS Administrator Seema Verma told STAT at a virtual event as reported by the Upper Midwest Telehealth Resource Center. “People recognize the value of this, so it seems like it would not be a good thing to force our beneficiaries to go back to in-person visits.”

CareFirst Blue Cross Blue Shield in Maryland already chose to have its telehealth program last through the end of the year back in May 2020. The program enables providers to extend telehealth care access to more patients when they do not have a platform of their own.

Aetna, Blue Cross Blue Shield Tennessee (BCBST), University of Pittsburg Medical Center (UPMC), and WellCare Medicare Advantage confirmed to HealthPayerIntelligence in May 2020 that they expected most of the coronavirus-era waivers and benefits would not become permanent.

That being said, some were already preparing for the long haul. In May 2020, BCBST was the first payer to make its coronavirus-era telehealth coverage permanent for in-network providers.

Meanwhile, by that same month, WellCare had already extended most of its coronavirus benefits and policies through the end of the year.

As of the time of this article’s publication, Aetna and UPMC have extended some of their coronavirus waivers until September 30, 2020, according to an updated post from America’s Health Insurance Plans (AHIP). Other benefits that these payers provide expired in mid-June 2020.

Payers have extended certain policies with little consensus, with deadlines scattered from August through December 2020.