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Nov 1, 2021

A new plan to address health needs for the most vulnerable

The vision of Blue Cross & Blue Shield of Rhode Island (BCBSRI) is to passionately lead a state of health and well-being across Rhode Island. And when we say “across,” we mean all corners of the state, and all segments of our population. We want to improve the health of ALL Rhode Islanders, including those who are the most vulnerable.

That’s one of the reasons why we have decided to enter the state’s dual eligible market and will offer a new plan starting in 2022. This plan – called BlueRI for Duals (HMO-DSNP) – is a dual special needs plan (DSNP) and addresses the needs of those who qualify for both Medicare and Medicaid.

For the purpose of this column, rather than focus on the plan itself, I want to focus on the “why” of our entry into the duals market, which in Rhode Island, is roughly 37,000 residents. Providing coverage for these vulnerable Rhode Islanders aligns perfectly with our goal of addressing the social determinants that affect health and well-being for so many.

Collectively this group faces many health challenges – more than half are living below the federal poverty level, more than 40 percent are disabled, and almost 25 percent of those who are over age 65 have Alzheimer’s disease. When you combine the comprehensive benefits offered by BlueRI for Duals with a coordinated approach – one that combines our expertise in care management with our extensive provider network – and our strong partnerships with local nonprofits and agencies that serve the dual-eligible population in our state, we’re confident that we will be able to successfully meet their health and healthcare needs.

We look at meeting those needs as our responsibility, and it’s an important one that we share with you, our participating providers.

Together, we’re accountable for caring for those who are in the most vulnerable position in our community. Unfortunately for this group, there is a dramatic inequity of access to resources for them to prioritize their health. Social determinants – such as availability of safe and affordable housing, access to food, transportation, and healthcare, safety, and many other factors – have a profound impact on overall health. Ensuring that we also address the health of this population means meeting these patients where they are and bringing health and life resources to them, which is quite a shift from traditional thinking of how medical care and resources are typically delivered.

This is something we started early in the COVID-19 pandemic, when we took steps to care for underserved populations, particularly our Medicare Advantage members, by delivering groceries to them. We also provided access to virtual care/telehealth at no cost to our members. And we’re continuing these benefits by including them as part of the BlueRI for Duals plan – it includes a $50/month grocery delivery; up to 50 one-way rides to and from doctors’ appointments and places in the community that are key to social networks and resources, like senior centers, libraries, and BCBSRI’s Your Blue StoresSM; weekly home meal deliveries following a hospital stay; daily living assistance through the “Papa Pals” program; and $0 telehealth visits.

In addition, members in this plan will benefit from the assistance of a health navigator, who will act as their personal guide and help them put together the pieces of the healthcare puzzle. These experts will work with members and their care team to address their specific health goals, to ensure that everyone involved is working toward the common goal of helping the member live their best life.

As always, thank you for all you do to help all our members and all Rhode Islanders live their best lives by staying safe and healthy. In November, we once again celebrate several health and healthcare observances: National Hospice/Palliative Care Month and National Family Caregivers Month, as well as Home Care Aide Week, November 7-13. So please take a moment to recognize and thank those who work in these areas for everything they do! And of course, we want to acknowledge Veteran’s Day on November 11 and thank everyone who has served for their commitment and bravery.