The Overlooked Patient: How Payers Can Identify, Engage, and Treat the Vulnerable Populations Not Participating in Their Own Care

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An often overlooked and underappreciated aspect of the U.S. healthcare system is that a substantial number of Americans are not participating in their own care, despite having access through health insurance.

The reasons why some people may not engage in their healthcare are myriad and complex. Challenges can stem from a range of causes, ranging from a mistrust in the medical system to social determinants of health such as transportation, food, or economic insecurities, to a lack of health literacy – all of which create voluntary or involuntary barriers to certain individuals seeking or obtaining proper medical care. Sometimes labeled “care- avoidant,” this population may not engage in medical care even at times when they suspect it to be necessary, when they are experiencing major health problems, and when they are showing signs of symptoms, according to a study in the Journal of General Internal Medicine.

Further, lack of participation is often intensified among people experiencing behavioral health issues, such as anxiety, depression and substance abuse, which can create additional challenges that result in both increased risk for and worsening of chronic medical conditions.

Description

An often overlooked and underappreciated aspect of the U.S. healthcare system is that a substantial number of Americans are not participating in their own care, despite having access through health insurance.

The reasons why some people may not engage in their healthcare are myriad and complex. Challenges can stem from a range of causes, ranging from a mistrust in the medical system to social determinants of health such as transportation, food, or economic insecurities, to a lack of health literacy – all of which create voluntary or involuntary barriers to certain individuals seeking or obtaining proper medical care. Sometimes labeled “care- avoidant,” this population may not engage in medical care even at times when they suspect it to be necessary, when they are experiencing major health problems, and when they are showing signs of symptoms, according to a study in the Journal of General Internal Medicine.

Further, lack of participation is often intensified among people experiencing behavioral health issues, such as anxiety, depression and substance abuse, which can create additional challenges that result in both increased risk for and worsening of chronic medical conditions.

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