More Thinking and Insights

SDoH Outlook for Pharmacy/Rx

April 11, 2021  |  Guidance


Yogin Shroff, Senior Partner and Chief Operating Officer

Healthcare organizations play an essential role in an individual's ability to overcome social risk factors impacting medication adherence that helps control chronic conditions, hypertension, and cholesterol.

Pharmacy Rx

Imperative to Stars success are the Pharmacy measures that support better health outcomes across both chronic disease measures and drug therapy. Countless individuals are struggling every day with medication adherence to control hypertension, cholesterol, and diabetes due to SDoH risk factors. Chief amongst those risk categories is food insecurity, limited transportation options, and impoverished levels of income. SDoH-influenced members often face the difficult decision of putting food on the table for their families vs. purchasing medications vital to their well-being. And in most (if not, all) cases, members choose to purchase food, which is often bought out of convenience due to limited or no healthy food options within a reasonable distance. Inevitably, this leads to worsening health conditions no matter what choice the member makes. This general economic instability can be controlled if the member is able to adhere to necessary medications to keep health conditions like blood pressure and cholesterol in control, whilst procuring a healthy diet to maintain low blood sugar levels. All of which can enhance positive health outcomes.

The Healthcare Organization's Role

Pharmacy deserts are precipitously becoming major risk factors for the underserved population. Like food deserts, this lack of pharmacy options is exacerbated by COVID-19. Due to this, health plans, systems, and providers are expected to play a vital function in coordinating the appropriate level of care for its members across the pharmacy spectrum. By channeling and harboring strong relationships with pharmacies in the network and strategically engaging with members, healthcare organizations can properly mitigate the unmet needs of its members and thereby increase overall Star ratings.

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