NASHVILLE, Tenn.—Five hundred Facebook friends are no substitute for face-to-face interactions, but many people today are swapping digital connections for tangible ones. That's partly why about a fifth of Americans struggle with feeling lonely, former U.S. Surgeon General Dr. Vivek Murthy said Thursday.
Speaking at the AHIP Institute & Expo in Nashville, Tenn., Murthy explained that lonely people live shorter lives and are more at risk for chronic illnesses like heart disease, depression, and dementia. Moreover, public health crises like the opioid epidemic and gun violence can trace roots back to loneliness and social disconnection, he said. Tackling those crises will require healthcare companies to make fostering relationships among patients with their communities a priority.
"For too long issues like social connection have been looked at as soft subjects—the stuff that we'll get to if we can get to it, after we get people the procedures and medications they need," Murthy said. "But putting it at the center of our concerns along with the other major drivers of health is important culturally speaking."
Some health insurers and healthcare systems are working to do just that by partnering with community organizations and employers or even having staff phone patients regularly so they feel less alone. It's part of a broader focus on the social determinants of health. Blue Cross and Blue Shield of Minnesota providing grants to communities to improve the social connectedness among their residents as those communities become more demographically diverse, said Dr. Mark Steffen, Blue Cross' chief medical officer.
A CareMore Health System program that treats loneliness like any other chronic disease is now being rolled out to Anthem's Medicare Advantage patients after initial results showed a 21% decrease in hospital admissions over a 12-month period, said Robin Caruso, the system's chief togetherness officer.
Under the program, CareMore's "togetherness officers" call the loneliest patients regularly and connect them with community resources for things like transportation or healthy meals. Those officers have made about 24,000 calls in two years and made 1,800 referrals to community resource and programs.
Cigna, meanwhile, has focused on raising awareness of the loneliness epidemic through research and encouraging employers to promote good relationships among workers.
A 2018 Cigna survey of 20,000 U.S. adults found that about half felt lonely or left out; 40% reported having no interactions with other people; and a quarter said they had no one to talk to. The survey also revealed that 18- to 22-year-olds reported feeling the loneliest and also reported feeling worse in health than older adults reported.
"That really told us we needed to step up and figure out what we can do to address loneliness,"
Dr. Douglas Nemecek, the Bloomfield, Conn.-based insurer's chief medical officer for behavioral health, said during an AHIP panel Thursday.
Cigna is working with its employer health plan clients to help them promote social connections in the workplace through resources they may already have, like affinity groups, volunteer activities or sports leagues. Cigna also has a program to keep caregivers who stay at home to care for a family member from losing their social connections, Nemecek said.
Cigna's focus on loneliness is part of a broader emphasis on integrating behavioral and physical health in its accountable care organizations and other value-based care programs. The insurer is working to create "medical neighborhoods" that bring together the primary care physician with the behavioral health specialists to improve communication between the two leading to more coordinated care, Eva Borden, Cigna's senior managing director of behavioral and medical solutions, said during another panel.
Dr. Cheryl Pegus, chief medical officer at Cambia Health Solutions, a Portland, Ore.-based company that is the parent company of six health plans in four states, said Cambia trained its customer service representatives in mental health first aid and moved to care management model in which a single nurse coordinates all care for a patient, bringing in behavioral health or other specialists when needed.
Cambia has also worked to address the opioid addiction crisis by reducing opioid prescribing by physicians and intervening at the point of sale at pharmacies. In January 2020, Cambia members will be able to get overdose drug reversal drug naloxone for a $0 copay, Pegus said.