Value Added: The Role of a Social Services Department in a Disease Management Company

Abstract

Disease management has evolved from the management of a single condition to assistance with many. A comprehensive health improvement and solutions program should address psychosocial, emotional and/or financial concerns related to a participant's care. A social worker can provide short-term therapeutic interactions to participants—reducing health-related risks. In addition, a social worker can help participants meet other needs, or they can advise or counsel a caregiver who is experiencing stress. The population studied includes all CorSolutions participants that have been touched by the Social Services department as of September 30, 2001. It looks at total referrals, type of referrals and potential financial impact of the Social Services department. From May 1, 1998 through September 30, 2001, the total number of referrals to the Social Services department was 3,447. A total of 1,624 participants were referred for concerns about the cost of medication. As it is already established that medication noncompliance can lead to exacerbation of chronic conditions, meeting the medication needs of participants can reduce hospitalizations and other healthcare related costs. A Social Services department should be an integral part of any health improvement and solutions program. Having Social Services available obviates ethical, legal and best practice questions, especially when addressing high-risk populations. Social Services helps remove barriers to participant care, engages in problem solving for participants around issues that impact their illness and/or capacity for self-care, and saves dollars by preventing, in many the need for emergent care.