How does companion care address Social Drivers of Health?

Social drivers of health (SDoH) impact upwards of 80% of health outcomes—and have been largely ignored by the health care system…until recently. Health plans and other industry players are increasingly recognizing the opportunity for non-traditional models of care to drive impact. One of those models is companion care, the new category of care created by Papa, which was designed to address individuals’ unique SDoH, including loneliness and social isolation.

Working through health plans and employers, Papa brings vital support and human connection right to a person’s front door when and how they need it, via our national network of vetted companions, called “Papa Pals.” 

Papa Pals meet health plan members’ social needs that promote health, but are non-medical in nature, like transportation to a doctor’s appointment or grocery shopping, caregiving support, and of course, social interaction. As Papa Pals gain access to members’ homes and hearts, they’re able to build trust—the greatest asset we have in health care.

While health plans and other stakeholders have generally struggled to access and understand people’s barriers to health, the bonds Papa Pals form give them much deeper insight. With this insight, Papa and/or a member’s health plan are able to connect members to vital services that can advance their health and well-being, addressing issues like food insecurity, home safety, and medication adherence.

I think the best examples of how companion care addresses SDoH are the personal ones. Take Papa member Lacey, a young mother of four on Medicaid in Michigan. Her Papa Pal, Michelle, provides child care support, advocates for Lacey and Lacey’s family at the food bank, and helps provide transportation to doctor’s appointments. It took Lacey time to be comfortable accepting help from a Papa Pal, but now she says that because of Michelle, she has a better outlook on life. “It’s like we fill a hole in each other’s hearts,” she said. “I’m really thankful for this relationship and I feel like it’s something everybody needs.”

At large, what impact does companion care have on the healthcare system? 

Addressing SDoH through Papa’s companion care model enhances members’ health and quality of life, improves health care utilization, and reduces overall health care costs.

We’ve seen a 64% increase in individuals reporting severe loneliness as part of our initial assessments from 2020-2022. Yet in the face of this loneliness epidemic, 60% of severely lonely individuals who actively participated in their health plan's Papa program experienced clinical improvements and moved to a lower category of loneliness, as determined by the three-item UCLA loneliness scale. We also reduced mentally unhealthy days by more than six days, per the CDC’s Healthy Days measure. 

Knowing loneliness is linked to increased risk of heart disease, stroke, diabetes, depression, and dementia, and that unhealthy days are associated with multiple chronic conditions and predict both hospitalization and mortality, these improvements are significant—and they refurberate through the health care system.

In an analysis of Papa among Meridian’s Medicaid population aged 45+ with a high rate of emergency department (ED) utilization, active Papa participants experienced a 25% reduction in ED visits, 14% decrease in hospital readmissions, and a 33% reduction in overall health care costs. Preventive cervical cancer screenings, diabetic eye exams and HbA1C testing for Papa participants also rose by 50%, 46%, and 35% respectively. While Papa is known for its work with older adults in Medicare Advantage, these results released just last week demonstrate the power of personalized, human help for historically hard-to-reach populations.

We’ve seen similar results across Medicare Advantage and socially isolated patient populations as well (stay tuned for these claims-based study results over the next few weeks!). Through trusted relationships and proactively addressing SDoH, companion care helps close social and clinical care gaps, supporting members’ well-being and reducing health care costs.

By addressing gaps in healthcare for older adults and families, can you share more about the improved member experience with companion care?

With companion care, members receive truly personalized support—when, where, and how they need it most—improving health plan perception and satisfaction, as well as overall health care experience.

We recently found that members who are severely lonely are less likely to view their health plan favorably, compared to those who are not lonely. Lonely individuals also reported they find it more challenging to get needed care right away and rated ease of getting prescription drugs and tests/treatments lower. After participating in Papa, the average member’s rating of their health plan moved from a 4-Star ranking to above the 5-Star threshold for the “health plan rating” CAHPS measure. Not only does this change have significant financial implications for health plans, but it demonstrates the far-reaching effects of proactively addressing loneliness. 

Companion care has also been shown to reduce the number of members who leave their health plans voluntarily, also known as member churn. It’s estimated that of the 28 million Medicare Advantage enrollees today, approximately 3.6 million will churn this year alone and, subsequently, $36 billion in revenue will be exchanged between health plans and/or traditional Medicare. Notably, in a study of a Florida-based health plan using Papa, Papa participants had a churn rate that was 15.8% lower than members who did not participate in Papa. Put differently, the study results indicate that Papa increased overall member retention by 2.8%.

Another component of improving member experience comes from Papa Pals’ ability to help members navigate their health plan benefits to resolve issues and enhance utilization, while removing complexity and confusion from their health care experience.

This example always stands out to me: One of our Papa Pals recently worked with a member to resolve a $10,000 medical bill. The Papa Pal learned of the issue during a visit and escalated it to our care navigators, who coordinated between the insurer’s claims department, the hospital, and billing company, ultimately resolving the issue and saving that member from an unimaginable amount of stress and anxiety.

Put simply, people need people. Personalized, proactive support delivered where health happens—in homes and communities—is key to reaching people across plans and geographies, and has a dramatic impact on member experience, health and wellbeing, all while reducing health care costs and improving health care utilization.

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Article written by Papa's Vice President of Health and Social Impact, Ellen Rudy, PhD