After a serious fall, Gayle* was having a hard time taking care of herself and had to move in with a family member who lived in a rural area. Limited mobility and a lack of transportation left her struggling to find the right resources to help manage her day-to-day health needs, including a way to get access to the prescriptions she needed.
Gayle’s story is a great example of the reality that 80% of a person's health is determined outside a doctor's office. Things like stable housing and access to transportation and food can have a profound effect on a person’s overall well-being. That’s why they’re also known as social determinants of health.
Gayle was struggling to manage her care needs and didn’t know where to turn. That’s when she met Corinne Crabtree, an Advocate4Me senior health care advocate with UnitedHealthcare. Corinne’s job is to help answer questions and make connections for people like Gayle.
UnitedHealthcare advocates have a wide range of qualifications, from nursing degrees to experience resolving highly complex health care claims issues. They also have access to a full team of clinicians, pharmacists and other members of the care team, so they can draw on many experts to help find solutions.
In Gayle’s case, Corinne started by finding a care professional in her new community. The next challenge was physically getting Gayle to the doctor’s office for an initial visit that was required before she could transition to virtual care.
“Gayle didn’t have transportation, so I needed to find some way to get her there,” Corinne said. “I was not letting this go without doing everything I possibly could to make sure Gayle was able to get to the doctor and get the medicine she desperately needed. Her life depended on it.”
Corinne used a new capability within the UnitedHealthcare Advocate4Me program that’s designed to help members who may be struggling to find community-based resources. By identifying the social determinants of health that may be problematic, UnitedHealthcare advocates can help remove barriers that are preventing a member from accessing the health care they need.
When eligible members like Gayle call the customer care team, advocates listen for phrases like “I lost my home” or “I don’t have a car” to help find low- or no-cost community resources.
While advocates are trained to listen carefully during conversations with members, they also know that it’s not always easy for people to share when they’re struggling with basic needs like food and transportation.
With the help of powerful technology and insights, advocates can create a highly proactive experience for members. Using predictive personalization, the Advocate4Me program:
- Automatically routes callers to an advocate whose skills and training match their needs
- Helps advocates quickly understand why the member is calling — before they even speak
- Brings up health opportunities before members even ask
Advocates are able to provide a personal, compassionate and simplified experience while helping members successfully navigate the health care system. Ultimately, this improved experience for the member may lead to lower costs and better health.
Through Advocate4Me resources, Corinne found a non-emergency ground transportation program that helps people like Gayle who lack dependable ride options.
“I checked back and confirmed that she did get to the doctor and was able to get the medicine she needed,” Corinne said. “That is what makes me love my job — helping people live longer, healthier lives.”
To learn more about Advocate4Me, visit uhc.com.
*Name changed to ensure privacy.