Exercise highlights health care frustration
Replaying the chaos she’d just been through, Jennifer Richardson started to get angry.
The staff leader at the United Way of Bexar County had roleplayed a patient during a mock demonstration at the San Antonio Food Bank. When it started, she didn’t quite know what to expect.
As she was discharged from the “hospital,” she was told that she had problems with loneliness and social isolation and should go to the community center because they might have resources for her.
Then she was sent to her insurance company, who referred her to a doctor’s office, but because there were no appointments available until January, she was sent back to the hospital.
“No one is telling me why I’m going to the doctor or what they think is wrong with me,” she said as she walked back to the table labeled “community center.” Someone there told her that she had to return to the hospital.
“It looks like I had to be dis
charged from the hospital three times before I get all the resources I need,” she said.
As she made one of her last stops, Richardson was told there were free classes at the community center so that she can learn how to cook eggplant.
The exercise, engaging dozens of San Antonio community health workers, would’ve been funny, they said, if hadn’t been an accurate depiction of a person navigating the current health care and social services system.
On the other side of the room, separated by blue tape on the floor, was a different scene.
Amelia Garcia, who works for a software company called Signify Health, said she was given a
screening during one visit to a hospital that determined where she should go for the resources she needed.
The role-playing event was organized by the San Antonio Health Advisory Board, which is comprised of local volunteers who work in health care, academic or social service agencies.
With San Antonio residents facing high rates of obesity and physical inactivity, the board is hoping to convince community partners to adopt a uniform way to screen for what they frequently call “social determinants of health,” which means little to people not engaged in health care and social policy.
“This phrase might be somewhat new jargon to a lot of people, but we know that these are the things that make up our health,” said Michael Guerra,
the food bank’s chief resource officer.
According to the Centers for Disease Control and Prevention, the conditions in the places where people live, learn, work and play affect a wide range of health risks and outcomes.
Humana, a health insurance giant with 1.8 million members in Texas, started its “Bold Goal” initiative in San Antonio, which spurred the creation of the advisory board in 2015.
The company’s goal was to improve the health in communities by 2020 by finding ways to address loneliness and social isolation, food insecurity and improving transportation.
By one measurement used by the CDC, San Antonio is showing improvement.
The public health agency measures unhealthy days by the total days a person feels physically or mentally unwell. In the past few years, Humana Medicare Advantage members living in San Antonio have been able to reduce their number of unhealthy days by 9.8 percent.
For each unhealthy day that a patient reports, the company found that there is about $15.64 higher medical costs per member each month. Angela Wolfe, Humana’s director of population health, said fewer days sick at home means less absenteeism at work.
While Wolfe said it’s hard to put an exact figure on the cost savings that would come with adopting a new health screening, there’s reason to believe better individualized health care would cost less in the long run.
Guerra said another way to lower health care costs is to address hunger.
The nonprofit Feeding America
says that $52.9 billion in health care costs was associated with not having enough food for regular meals among adults and children in the United States in 2016.
Texas has the second highest health care costs per capita at $223, trailing behind Mississippi by $20.
In Bexar County, adults who cannot afford to eat healthy foods pay $1,860 on average more annually in health care costs.
“The numbers are pretty staggering,” Guerra said.
When people do not have adequate access to enough nutritious foods, they skip or delay medication refills and clinic visits, which increases their risk for chronic diseases such as diabetes and hypertension.