How CareSource Puts Families Before Profits

January 9th, 2023 | 5 min read

Two daughters smiling hugging their mother

Improving health care in Georgia begins by addressing the social determinants of health, non-medical factors that influence health outcomes. These factors can include education, neighborhood environment, access to food and health care, as well as economic and financial conditions. For example, lack of affordable housing, while not a medical issue, affects health in many ways — from potential exposure to lead or asbestos to lack of a safe place for children to play and increased stress due to fear of eviction. Racial inequalities also play a role in social determinants of health. The CDC reported in 2018 that Georgia ranked in the top five states for highest maternal mortality rates in the country, especially among Black women, highlighting a significant racial disparity.

For decades, it has been the responsibility of the medical community to improve health outcomes. Although medical care greatly influences health, numerous studies have shown that addressing social determinants of health and improving health equity can positively affect health outcomes for populations.

National Library of Medicine article cites studies that have attempted to show the effect of social determinants of health on overall health. A review by McGinnis et al. concluded medical care was responsible for only 10-15% of preventable deaths in the U.S.: “Half of all deaths in the U.S. involve behavioral causes, and other evidence has shown that health-related behaviors are strongly shaped by social factors, including income, education and employment.” In addition, The American Journal of Accountable Care reported some estimates conclude that medical care alone (e.g., doctor’s visits, medications and treatment plans) addresses only about 20% of health outcomes. These and other studies show understanding the environmental and social factors that contribute to the well-being of an individual is essential to improving overall health.

CareSource, the state’s only nonprofit Medicaid plan, now serving over 500,000 Georgians, is committed to advancing health equity across Georgia through partnerships with community organizations that address social determinants of health.

Why nonprofit status matters

Health plans can be classified as nonprofit or for profit. The biggest difference between the two is that nonprofit health plans are not beholden to investors. Because they are not pressured to distribute profit margin to shareholders, nonprofit health plans can invest these additional dollars back into the community. In many instances, they are donated to nonprofit organizations that align with the mission and vision of the plan.

This distinction is important in addressing the social determinants of health and advancing health equity. It takes the community working together to improve health outcomes. When managed care organizations and other health insurers partner with organizations that help solve issues contributing to health disparities, we can begin to improve the health of members.

Partnerships with organizations outside of health care

CareSource, for example, partners with organizations across the state that address non-medical factors that can impact health.

1. Financial literacy: Financial literacy can reduce stress that leads to disease, set families and individuals up for safe and stable home ownership, and help identify funds for purchasing health care and healthy foods. To help improve money management acumen, CareSource provides our members with free access to Atlanta Habitat for Humanity’s comprehensive financial literacy program. This program allows CareSource members to participate in financial education courses and confidential one-on-one coaching sessions to help them set and achieve savings goals, as well as plan and implement strategies to improve their financial health.

2. Literacy: Twenty-one percent of adults across the U.S. have low literacy skills. Imagine trying to navigate a complicated health system without the ability to take in written information. This is why CareSource has committed nearly $300,000 (from 2021-2024) to Reach Out and Read, an organization that promotes early brain development, literacy, relationship and school readiness by giving new, developmentally appropriate books to children and advice to parents about the importance of reading aloud.

Organizations directly addressing social determinants of health

In addition to supporting organizations that may seem non-traditional in the medical sense, when health care companies partner with organizations that directly tackle social determinants of health, the partnership can make a big impact on health equity.

For this reason, CareSource recently donated $2.55 million to Easterseals to help Easterseals respond to disparities in health care, education and employment exacerbated by the global pandemic among children and adults with disabilities, including veterans and seniors. The funding will also support Easterseals’ Project on Education and Community Health Equity, an initiative focused on addressing the educational and health care needs of children with disabilities, including children with disabilities of color, so they are kindergarten ready and can reach their full potential.

The adage “it takes a village” is especially true when it comes to solving health inequities in our state. Nonprofit managed care organizations are in a unique position to provide funding and support to other organizations addressing these needs in the community. When we work together, Georgia can become a more equitable, healthier community.