New maternity program promotes safer pregnancies through personalized care

New maternity program promotes safer pregnancies through personalized care
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Initiative helps address maternal health crisis by informing expectant moms about the potential benefits of low-dose aspirin to prevent preeclampsia

WOONSOCKET, R.I. — To help address the unprecedented maternal health crisis affecting American women and support prenatal and postpartum care, Aetna, a CVS Health (NYSE: CVS) company, has launched a new initiative as part of the Aetna Maternity Program.

"Over the past two decades we've seen a steady rise in pregnancy-related deaths, and significant racial and ethnic disparities persist that can lead to poor maternal outcomes," said Troy Brennan, M.D., CVS Health Chief Medical Officer. "The main contributors to this crisis reflect deep-rooted issues within our health care system that we must address, including limited access to care."

Building on a long-standing commitment to connect expectant moms with care that meets their unique needs, this first-of-its-kind initiative is focused specifically on preventing preeclampsia. Preeclampsia is a leading cause of maternal and infant illness and death that is characterized by new-onset hypertension during pregnancy. Preeclampsia can lead to serious maternal complications, including stroke, seizure and organ failure and accounts for 15 percent of all preterm births in the U.S. Rates of the condition have increased 25 percent in the last ten years alone.https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication

According to the World Health Organization, the U.S. is one of the only high-income countries where deaths related to pregnancy or childbirth are on the rise. Black women are also being disproportionately affected, with rates of severe maternal morbidity and mortality two to three times that of white women.

The COVID-19 pandemic has presented new challenges, as many expectant moms may be attending fewer in-person prenatal care visits. In turn, they may increase their risk of developing complications that go undetected.

Recent recommendations by the U.S. Preventive Services Task Force (USPSTF) and multiple medical professional societies recommend low-dose aspirin for the prevention of preeclampsia for women at high risk for developing the condition. By leveraging data analytics, the Aetna Maternity Program identifies pregnant women with risk factors for developing the condition for individualized outreach and education. Women at high risk are sent a personalized prenatal care kit that contains educational materials along with an 81-mg bottle of low-dose aspirin, a low-cost intervention that may reduce the risk for developing the condition. Members receive an appointment reminder card encouraging them to speak with their pregnancy care provider about the potential benefits of low-dose aspirin and whether it is right for them. All pregnant members are also mailed information developed by the Society for Maternal-Fetal Medicine on preeclampsia and prevention steps.

"This is an innovative, simple way to promote safer pregnancies by enhancing awareness about an important cause of maternal and infant harm," said Daniel Knecht, M.D., Vice President of Clinical Product for CVS Health. "This initiative is also designed to help close gaps in knowledge by supporting members in conversations with their providers."

Low-dose aspirin as a preventive therapy

While there is no cure for preeclampsia, taking one low-dose aspirin a day has been shown to reduce the risk of the condition and some of its complications. Pregnant women with risk factors such as hypertension, Type 1 or 2 diabetes, obesity, and a history of preeclampsia benefit from the use of prenatal aspirin, according to the USPSTF. When this therapy was started in the first trimester in at-risk women, it reduced the incidence of hypertension by 24% and preterm birth by 14%.

To further support women's health, Aetna is exploring additional ways to partner with network physicians and provide this latest guidance.

"CVS Health has delivery channels that can bring critical information and resources such as low-dose aspirin right to members' doorsteps. This outreach is coupled with a care management program featuring highly trained and dedicated nurses to support the personalized needs of pregnant members," noted Joanne Armstrong, M.D., head of Women's Health for CVS Health and an OB/GYN.

For more information about the Aetna Maternity Program and the company's efforts to prevent preeclampsia, click here.

About CVS Health

CVS Health employees are united around a common goal of becoming the most consumer-centric health company. We're evolving based on changing consumer needs and meeting people where they are, whether that's in the community at one of our nearly 10,000 local touchpoints, in the home, or in the palm of their hand. Our newest offerings from HealthHUB locations that are redefining what a pharmacy can be, to innovative programs that help manage chronic conditions are designed to create a higher-quality, simpler and more affordable experience. Learn more about how we're transforming health at www.cvshealth.com.

Contact

Kathleen Biesecker
bieseckerk@aetna.com
703-472-8466

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Helping members stay well, at home

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In the wake of the COVID-19 pandemic, employers and other benefit plan sponsors are searching for more ways to support members’ health. People are experiencing both physical and mental challenges as they cope with isolation, economic hardship, disruptions to normal work and school routines, and the virus itself.

CVS Health is making it easier for employers and health plans to meet these growing challenges with the expansion of our Point Solutions Management offering. This program enables plan sponsors to more efficiently administer apps, online trackers and other digital point solutions that support their members’ self-care routines at home.

“Digital point solutions can help people manage important wellness areas like mental wellbeing, fitness and weight loss from the safety and convenience of their own homes,” said Sree Chaguturu, MD, Chief Medical Officer at CVS Caremark. “Employers and other plan sponsors increasingly are looking for better ways to include these kinds of tools in their benefits packages — especially in light of the COVID-19 pandemic.”

The recently added solutions have passed CVS Health’s rigorous vendor evaluation process to ensure that they support health outcomes while helping to reduce costs. The five new point solutions available to CVS Caremark clients through Point Solutions Management include:

  • Daylight: A fully automated and highly personalized mobile app to tackle worry and anxiety, based on cognitive behavioral techniques. 

  • Naturally Slim: An online program that uses informative videos and learning tools to teach individuals how to lose weight and improve their overall health.

  • Vida: A weight loss program with an app that pairs individuals one-on-one with a health coach, helping members achieve their health goals through phone and video conversations.

  • WW: Weight Watchers reimagined — A weight loss app providing access to food and fitness trackers, thousands of delicious recipes, and community support.

  • Kurbo: A digital program for children and teens ages 8 to 17 that teaches users how to make healthier choices and lifestyle changes through weekly video coaching, in-app chat, messaging, games, and educational videos.

These solutions join Hello Heart, Hinge Health, Sleepio, Torchlight, and Whil that are available to CVS Caremark clients through our Point Solutions Management program.

Point Solutions Management is a full-service offering that leverages the CVS Caremark pharmacy benefit management (PBM) infrastructure to help clients evaluate solutions, streamline vendor contracting, billing, eligibility verification and reporting. In total, ten solutions are now included as part of the program — addressing a broad range of health care concerns including chronic condition management, musculoskeletal health, stress reduction, mental health management, weight loss, and caregiver support.

This expansion is the latest in CVS Health’s ongoing innovation strategy, focused on meeting emerging client and member needs — while responding to acute concerns arising during the COVID-19 pandemic. We will continue to regularly evaluate and update the offering to include additional vendors that support improved outcomes and help lower costs across key areas of health, including fertility, financial wellness and the social determinants of health.

For plan sponsors interested in learning more about Point Solutions Management, please visit the Point Solutions Management page on our Payor Solutions website.

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Addressing maternal mortality rates

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The United States is one of just a few high-income countries where deaths related to pregnancy or childbirth are on the rise. 

“It is more dangerous now to have a baby in the U.S. than it was two decades ago,” says Dan Knecht, MD, CVS Health’s vice president of clinical products. “That’s really alarming.”

Watch the video to see how CVS Health and Aetna’s combined capabilities are trying to turn that trend around by getting expectant mothers on a path to better health.

The company’s efforts include: 

  • Looking at racial disparities, including social determinants of health

  • Identifying high-risk patients through analytics

  • Mailing bottles of low-dose aspirin to expectant mothers to help reduce the risk of preeclampsia

  • Dedicated nurses working directly with members

“We have delivery channels that I think both surprise and delight patients through the retail side,” says Joanne Armstrong, MD, senior director of clinical solutions for CVS Health. “And then we combine that with a care management program where we have highly trained, dedicated, and passionate nurses who understand this clinical area, understand the diseases we're talking about and have relationships with the patients.”

COVID-19 has complicated matters further, but, again, CVS Health has stepped up to help. Along with an algorithm to help identify at-risk patients, liberalized telemedicine policies have allowed more virtual checkups.

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Age-friendly care for older adults

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People over the age of 65 make up an increasingly large part of our population. By 2030, it is predicted that there will be 74 million older adults in the United States. For many of us, this includes our parents, grandparents, friends and neighbors. Older adults also make up a growing percentage of the patients seen at MinuteClinic.

Recently, The John A. Hartford Foundation sponsored a partnership between MinuteClinic, Case Western Reserve University Frances Payne Bolton School of Nursing and the Institute for Healthcare Improvement to produce training tools and resources that will be used at MinuteClinic to further improve and evolve how we care for older adults. 

This training will enable MinuteClinic to move towards the adoption of the Age-Friendly care in every clinic nationwide for patients 65 years or older, by the beginning of 2021. These age-friendly visits will include questions around the “4Ms Framework” — What Matters, Medication, Mentation and Mobility, and providers will also share healthy aging tips and suggestions older patients can implement in their everyday life.

Research shows that providing the older adult population with specific, age-friendly care has significant benefits, including a reduction in the number of emergency department visits, hospitalizations and hospital readmissions, improved mobility, a reduction in medication-related problems and early identification of memory loss and depression.

By applying the “4Ms,” MinuteClinic providers will be able to positively impact many of our patients, in a setting that they are comfortable and familiar with. For those opting to seek care through E-Clinic visits, providers will also be able to assess the “4Ms” while patients are in the safety and comfort of their own home.

MinuteClinic is currently implementing the “4Ms Framework” across all locations, with the goal of being recognized as an exemplar of age-friendly care in early 2021. MinuteClinic is pleased to be the largest retail clinic network in the U.S. to adopt age-friendly care system-wide.

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Most adults are experiencing more stress than same time last year, new report shows

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New CVS Health national survey reveals negative effects of COVID-19 on mental well-being, particularly for frontline health care workers

According to new data, COVID-19 is exacerbating risks to mental health — especially among health care workers — and hindering accessibility to find care. More Americans are considering emerging services to improve access, such as telemedicine.

In a recent nationwide survey conducted by CVS Health and Morning Consult, two thirds of adults indicated they are experiencing more stress compared to this time last year, and more than 60 percent feared the impact of COVID-19 on their health. Stress has increased particularly among health care workers (75%) who are on the frontlines battling the pandemic.

Frontline health care workers are also reporting higher levels of harmful behaviors as a result of COVID-19. Approximately half of health care workers noted that COVID-19 has reduced their sleep schedules (54%), worsened their diet (51%) and had an overall negative impact on the state of their mental health (48%). A quarter also reported an increased desire to drink alcohol or use illicit substances.

“Rising stress and fear clearly demonstrate the existence of a ‘second curve,’ which is the less visible but escalating mental health crisis resulting from the COVID-19 pandemic,” said Cara McNulty, DPA, President, Aetna Behavioral Health. “We need to continue to move fast to ensure we are connecting those on the front lines of the pandemic with mental well-being resources.”

To help flatten this second curve, CVS Health has increased access to several no-cost mental health resources through targeted financial support, such as outpatient counseling for hospital-based employees in New York, New Jersey and Connecticut via Give an Hour.

CVS Health has also made Aetna's Resources for Living (RFL) program available to everyone, which includes real-time phone support to help callers cope with the emotional impact of the pandemic (accessible by calling 1-833-327-AETNA or 1-833-327-2386).

According to the survey, nearly one-in-three adults are very likely to use mental and emotional health care services if they are provided by their health insurance provider, and more than half would find them useful. Additionally, half of respondents are familiar with telemedicine services. Approximately 50 percent of adults are willing to try speaking to a personal licensed therapist via video or phone, and 48% would communicate via text messaging or a mobile application.

Surveyed adults also report a lack of familiarity with employee-assistance programs (EAPs), which typically offer in-the-moment counseling services over the phone, resources to relieve stress, wellness programs and more. Only eight percent of respondents have utilized one in the past, and nearly 40 percent have never heard of an EAP.

Morning Consult poll conducted from April 28 to May 3, 2020 among a national sample of 2,200 adults and 500 frontline health care workers.

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How telehealth connects patients to care

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Through virtual visits we’re helping more people on their path to better health. For many, it’s a new kind of care.

Adam Pellegrini Portrait
"As the country reopens, telehealth will play an important role providing health care,” says Adam Pellegrini, Senior Vice President, Transformation Consumer Innovation and Enterprise Virtual Care.

As COVID-19 began to spread, ChuckName changed to protect patient privacy. , a 62-year-old chef with a heart condition, sheltered-in-place at his partner’s remote Colorado ranch. After developing a fever, cough and upper respiratory symptoms, Chuck scheduled a telehealth visit, which allows patients to virtually consult a doctor by video chat or by phone. 

Like 90% of Americans before the pandemic, Chuck had never tried telehealth services. Now, with health insurers temporarily waiving co-pays and the federal government easing regulations, telemedicine may have reached a tipping point.

“I had a lot of anxiety,” says Chuck. “That stress was alleviated knowing that I could be in the middle of nowhere and feel like I have a doctor right there by my side.”

As the country reopens, telehealth will play an important role providing health care, says Adam Pellegrini, Senior Vice President, Transformation Consumer Innovation and Enterprise Virtual Care, CVS Health.

“We are focused on how we can help the consumer navigate to the right care for the right medium in a way that has the best health outcome.”

Like Chuck, nearly three-fourths of respondents in a 2020 survey would consider using a telehealth service if they had COVID-19 symptoms, and two-thirds say the pandemic increased their willingness to try telehealth in the future.

In the first quarter of 2020, virtual visits though MinuteClinic® locations grew about 600% over the same quarter in 2019. Aetna also experienced a dramatic increase in daily telehealth engagements. 

Going forward, telehealth will be an integrated part of an individual’s overall health care journey, says Pellegrini, citing CVS Health’s unique combination of Aetna’s broad network of health care providers and its nearly 10,000 retail pharmacies in communities across the United States. 

“Because of the holistic approach we have with our assets, we can actually map a patient’s entire care process to make it as seamless and as frictionless as possible,” says Pellegrini.

“Early action keeps people healthy, which benefits patients, doctors, and insurers,” says Justin Steinman, Vice President, Commercial Products, for Aetna. “If we can get you to care quickly because telemedicine is convenient, it’s going to be a win-win-win for everybody.”

Chuck, now 100% recovered, expressed enthusiasm for new ways to use telemedicine. “It’s exciting that even during a stressful time, I’ve had an experience like this open me up to a possible paradigm shift in my connection with the medical community,” he says. “Sometimes real good comes out of tough times.”

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Flattening the second curve

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As we combat the physical effects of COVID-19 pandemic, many of us are simultaneously confronted with deep feelings of stress, fear and anxiety. We are facing profound loss, economic uncertainty, social isolation, and worry for the health of those we love. This time of mental and emotional crisis is the ‘second curve’ of the pandemic, and we must work together to flatten this curve, too.

If you are struggling, please know — you’re not alone.

In times of great need, there will always be great helpers and heroes — those who go above and beyond to keep others safe and comfortable, heal sickness, and provide access to essential services and resources. In the wake of this pandemic, these helpers and heroes have missed sleep, lost jobs, mourned loved ones and become infected themselves — all while staying committed to helping and serving others. These helpers need help, too.

To answer that call, CVS Health is stepping up our commitment to supporting those who care for us by connecting them with mental wellbeing resources and counseling services designed to address their needs during this unprecedented and difficult time.

We’re proud to now offer expanded services and resources to support our most significantly impacted groups — our frontline health care workers, our essential workers, our seniors, and our furloughed and laid-off workers. Read on to learn more.

Maintaining mental wellbeing right now is more important, and more challenging, than ever. We can help.

Read the infographic


Impacted? We’re here to help.


Frontline health care workers

Through support from CVS Health and the Aetna Foundation, we are working to address the needs of the health care workforce by offering access to no-cost mental health counseling via Give An Hour.

  • Give An Hour offers personalized counseling to hospital-based clinical and non-clinical employees, and loved ones of essential hospital workers in New York, New Jersey and Connecticut to help manage trauma responses including, depression, anxiety, and post-traumatic stress. Access support from Give an Hour.

Aetna’s signature Resources For Living (RFL) program is also offering a variety of wellbeing resources and support options to those in need, whether or not they’re covered in Aetna insurance plans. Individuals who do not have RFL as an insurance plan benefit should call 1-833-327-AETNA (1-833-327-2386) for assistance. RFL resources include:

  • In-the-moment phone support to help cope with the emotional impact of the event

  • Guidance for frontline workers on how to cope with the traumatic stress effects of COVID-19


Essential workers

CVS Health is committed to helping essential workers, including grocery, pharmacy and service employees, who are also on the frontlines of the pandemic.

Aetna Resources For Living (RFL) is providing mental wellbeing services, in addition to identifying resources to support basic needs such as meals, childcare, eldercare, and financial guidance. Services are available to all even if your insurance plan benefits do not include RFL.

  • Get real-time phone support to help cope with the emotional impact of the pandemic. Call 1-833-327-AETNA (1-833-327-2386)

  • Listen to podcasts about relevant topics such as grief, loss, resiliency, self-care, and empathy

  • Discover ideas for things to do with your kids while you’re together at home


Seniors

Staying connected during social distancing can be challenging, especially for seniors who are most at risk for social isolation. We’re here to help.

Aetna Resources For Living (RFL) is providing wellbeing and emotional support for seniors, expanding social connectedness outreach. Additionally, through RFL, seniors can access support for basic needs including food, prescription, and meal delivery services. If you need assistance, call RFL at 1-833-327-AETNA (1-833-327-2386).


Furloughed or unemployed

A job loss can take a toll on your mental wellbeing. Resources are available to help you address fears and anxiety.

Aetna Resources For Living (RFL) is providing support for basic needs. Resources include emotional support for coping with job loss, family meals, and financial guidance. To speak to someone, call 1-833-327-AETNA (1-833-327-2386).


CVS Health colleagues

Resources are also available to help CVS Health colleagues build mental health resilience, cope with uncertainty, reduce stress and stay connected.

  • 7 Cups provides free, on-demand emotional health support services that make behavioral health care accessible through community, trained volunteer listeners.

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Quarantined seniors face unseen dangers

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With an increased risk of severe illness from COVID-19, the Centers for Disease Control and Prevention (CDC) advises that adults 60 and older "stay at home as much as possible." But, studies show that isolation and loneliness can cause seniors physical and mental harm. In fact, it can be more harmful to a person’s well-being than obesity or smoking 15 cigarettes a day.

Why loneliness is lethal

The first step in finding solutions is to understand that loneliness and social isolation are related, but different problems, says Dr. Christopher Lim, M.D., Senior Clinical Advisor, Aetna Medicare. Isolation is objective and can be measured by factors like the size of a person’s social network. In contrast: Loneliness is a subjective and personal feeling. Both are common among older adults.

A 2020 study found that nearly a quarter of Americans aged 65 and older are socially isolated, and some 43% of adults aged 60 or older report feeling lonely. Add on the isolation felt with the pandemic, and these people face increased risk for heart attack, stroke, or even reduced antiviral protections that are so important right now.

“Loneliness is not a normal state of being for a human,” says Lim. “Biologically, we depend on others to survive in the world.”

Making connections

Fortunately, there are ways we can all help older adults stay connected while respecting social distancing:

  • Resources For Living consultants call at-risk seniors identified by the Social Isolation Index to offer customized local solutions, such as food delivery.

  • SilverSneakers, now offers members age-appropriate online video workouts from home.

  • Papa, Inc. program connects college students and seniors through “Assistance from a Distance” to encourage positive thinking, help with ordering groceries and medicines and explaining telehealth tools.

  • Through an Aetna Foundation grant, the Meals on Wheels program is developing a training curriculum to teach seniors how to use technology to make online connections.

Dr. Robert Mirsky, Chief Medical Officer, Aetna, talking with an older woman outdoors.
Dr. Robert Mirsky, Chief Medical Officer of Aetna.

“We are continuing to look holistically at our social connectedness offerings to build out a variety of approaches to identify and support our members who are lonely or isolated,” says Dr. Robert Mirsky, Chief Medical Officer for Aetna Medicare.

You can help, too. Consider adding your neighbor’s shopping list to your own. Call your elderly relatives to remind them they aren’t alone. Schedule a virtual visit between your children and parents. The connections you make during this time could be lifesaving.

Help older adults stay connected

  • Make a plan how to social distance and sanitize their home. Update phone numbers for pharmacy and other home deliveries.

  • Schedule regular phone calls and video chats.

  • Organize a virtual game night using online board games or set up identical game boards and use a speaker phone. 

  • Create a virtual book club or have grandparents read bedtime stories.

  • Host a long-distance dinner party with meal delivery and phone or video conversation.

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Women’s heart attacks aren’t like men’s

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"I’ve always lived a healthy lifestyle," says Tasya Lacy from Columbus, Ohio, who has been teaching hula-hoop fitness classes for years. Yet, the day before Easter 2016, at age 50, she had a heart attack.

"I was exhausted and felt like I pulled muscle in my back," Tasya, now 54, recalls. "My husband rubbed my shoulders and felt my heart racing. He told me we we're going to the hospital. I didn’t think I needed to.”

Doctors found 99% blockage in Tasya’s main coronary artery, requiring three stents.

It’s common for women to miss signs of a heart attack because they present differently from men. A man is more likely to have chest pains, a woman may experience flu-like symptoms: nausea and vomiting, excessive sweating, exhaustion, or pain in their arm or back.

Listening to your body could be the difference between and life and death. Literally. According to the American Heart Association (AHA), cardiovascular disease is the No. one killer of women, causing one in three deaths each year. Often because they ignored the symptoms. And, 20% of women age 45 or older who have who have a heart attack will have a second heart attack within five years of their first.

CVS Health is the national presenting sponsor of Go Red for Women — the American Heart Association’s heart health movement to end heart disease and stroke in women.

MinuteClinic® offers chronic care management and preventative care all year long, including measuring risk factors for heart disease. “We’ve expanded our available health care services for patients with certain chronic conditions such as diabetes, high cholesterol and high blood pressure,” shares Angela Patterson, Chief Nurse Practitioner, MinuteClinic. “Our providers are able to screen, assess, treat and monitor these conditions, as well as order lab tests, recommend lifestyle changes, prescribe medications and educate patients about their conditions.”

There's one more risk factor exclusive to women: menopause.

"The combination of estrogen and progesterone before menopause seems to provide a protective element against heart disease in women," explains Allan Stewart, MD, Medical Director for HCA East Florida’s Miami-Dade Cardiovascular Surgery Programs. However, once a woman goes through menopause, her risk of heart attack increases significantly.

Tasya was post-menopausal when she had her heart attack. Now she knows a simple truth about her health — when in doubt, always seek medical care.

Get proactive with preventive care

Visit a MinuteClinic to learn your personal health numbers — a starting point for a discussion with your health provider on your risk for heart disease: Total cholesterol, blood pressure, blood sugar and body mass index (BMI).

Visit cvshealth.com/GoRed to learn more.

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Addressing social isolation among seniors

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With studies showing social isolation can be as damaging to your health as smoking a pack of cigarettes a day, loneliness can be just as dangerous as high blood pressure and high cholesterol.

That's why addressing social isolation is a major focus for Aetna’s Medicare business and care managers, who are taking a more holistic view of senior health to help get them on a path to better health.

With studies showing social isolation can be as damaging to your health as smoking a pack of cigarettes a day, loneliness can be just as dangerous as high blood pressure and high cholesterol.
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“The most common challenge with our senior patients, honestly, is that so many of them have no one,” says Aetna Field Case Manager Sarah Fischer, RN. “So many of them don’t have families. One lady said to me, ‘I’m the only one left.’"

Watch the video to see how case managers are introducing seniors to benefits such as the SilverSneakers fitness program, community volunteering and other opportunities for social connection.

“We get them involved, get the area office on aging involved. There are senior newspapers, things like that,” says Sarah. “We just bring these benefits to the member and say, ‘Let’s get you involved in something.’”

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