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Embedding social determinants into care plans

Care managers with our Humana At Home program began screening members for social determinants of health to enhance care management and planning.

“We screen members who are new to our Humana At Home programs for food insecurity and social isolation and loneliness. I work with them individually to build a care plan that includes steps they can take to stay socially connected. For one of my clients, this means attending a weekly grief support group in her community, where she can connect with other seniors who have lost their spouses. I help arrange her transportation through either a friend or a local service to make sure she has a way to get there each week. We also track Healthy Days measures for all of the members we work with, so we can see impacts over time.”
– Karen Bales, Humana At Home Care Manager

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