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Exploring the Social Factors Impacting the Under 65 Duals Eligible Market

 

By Kyle Janssen

Dual eligible Medicare and Medicaid members are, by definition, more in need of assistance with both medical and non-medical needs compared to other consumers. Even among Duals though, there is one group that has more needs and barriers facing them than others—the Duals Under 65 group.

Deft Research’s 2024 Dual Eligible Acquisition Study aimed to understand which communication channels and benefits would best help move seniors from state Medicaid coverage into D-SNP plans. It also evaluated Dual members’ perceptions of carriers in their region, and their awareness of and willingness to consider those brands in the future. One way in which Deft Research was able to identify certain needs for each studied group of Dual eligible members is through various Social Determinants of Health (SDOH).

Research conducted by the World Health Organization (WHO) suggests that health outcomes may be impacted by SDOH factors by as much as 55%,1 with such factors considered to have a greater impact on health than either genetic factors or access to healthcare services.2 For the Dual Eligible Acquisition Study, Deft Research evaluated the impact of 10 SDOH factors on Duals and Low-Income Non-Duals.

Out of the four tested groups of Dual eligible consumers (Low Income Non-Duals, Full Duals, Partial Duals, and Duals Under 65), Dual members under 65 were more likely to report experiencing six or more of the tested SDOH factors, along with having more health barriers. Specifically, these Dual members reported very high rates of food insecurity.

Switching rates during the AEP have nearly doubled from only two years ago. In 2024, their main reason for switching was that they wanted a bigger flex card allowance, which usually includes grocery store benefits that can help cover the costs for certain foods.

Duals Under 65 not only have a low household income but are also more likely to have a larger household than any other Dual type. Larger households mean having more mouths to feed every day. Tie that to their high rates of food insecurity—along with day-to-day living expenses—and access to plans that have a grocery benefit and other allowance-based benefits is paramount to help these consumers.

To learn how to purchase the recently published 2024 Dual Eligible Acquisition Study click here https://bit.ly/3TzomBz.

References:

1Social Determinants of Health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

2Why Is Addressing Social Determinants of Health Important for CDC and Public Health? Centers for Disease Control and Prevention. https://www.cdc.gov/about/sdoh/addressing-sdoh.html#:~:text=SDOH%20have%20been%20shown%20to,higher%20risk%20of%20premature%20death

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