Helping Medicare recipients unlock critical resources
Anna de Paula Hanika, CEO and Co-Founder, Uno Health
The coronavirus has severely impacted America’s low-income seniors and disabled, who were already living on a knife’s edge before the pandemic hit. But what if there were a way to tap into thousands of dollars in additional support?
Over the past couple years, health care experts have been talking a lot about the social determinants of health (SDoH) — how the conditions where people live and work can affect outcomes for their health. Even before the coronavirus outbreak, nearly half of Americans over the age of 65 lived at or below the federal poverty line of $30,000 a year. Many of them face a daily menu of impossible choices: Fill a vital prescription, or buy healthy food? See a doctor, pay a utility bill?
Today, with COVID-19 wreaking unprecedented havoc on people’s finances, the situation has gotten even worse. Resources previously available, such as soup kitchens or community centers, closed overnight. Family members who were helping to pay bills have lost their jobs. For many people, the idea of stocking up with enough supplies to last weeks of self-quarantining is simply out of the question. Sadly, they face the stark choice between safely isolating, or being able to eat three meals a day.
As it turns out, though, there’s hope for low-income seniors and those with disabilities. Up to fifty percent of those who qualify for Medicare are eligible, but not enrolled, in federal and state-level programs such as food stamps, utility assistance, prescription assistance, and discounted phone lines. Tapping into these programs can unlock tens of thousands of dollars per person in direct cash and savings every year.
So why aren’t Medicare recipients able to unlock the extra money that’s available to them? Unfortunately, many people don’t even know these programs exist, never mind how to take advantage of them. Every state in the U.S. has several dozen programs, each with its own agency and complicated multi-page application form. Many programs even require you to show up in person to apply, something that’s often physically impossible or financially prohibitive for a low-income senior or disabled individual with mobility issues. Adding all those hurdles up, and it can take weeks to get all the paperwork done. It’s no wonder so few eligible people apply for these programs!
Introducing Uno Health
The good news is that those eligible for Medicare aren’t the only ones motivated to solve this problem. Their health insurance companies are too!
Because of the “SDoH” — social determinants of health — mentioned above, Medicare insurance companies tend to focus their efforts on elderly, lower-income individuals whose health outcomes are strongly influenced by their lack of financial means. The time-consuming burden of figuring out how to save money for this group of people can often fall on clinical staff, whose expertise is on health and not finance.
I saw this time and time again when I worked at Clover Health, a tech and data-enabled Medicare Advantage company. Whether we were calling someone to remind them to take their meds, or trying to enroll them in a care management program, all too often the barrier was lack of finances. And almost always, our team would resort to Googling a program that could give our members a bit of extra cash. This kind of work was out of scope of our expertise, and would take hours out of precious time with members.
After realizing there were also revenue opportunities for Medicare Advantage plans (enrolling people into a couple of specific programs results in a ~20% increase in their monthly premium revenue), Chloe and I decided to found Uno Health — it was too much of a no-brainer. We knew that there was a huge potential for technology to significantly decrease the enrollment burden for both beneficiaries and their care teams, making it easier to unlock the billions of dollars left on the table every year.
Uno is a tech-enabled service that makes it easier to enroll low-income Medicare members through their insurance plans or doctors into many of the low-income programs for which they’re eligible, including Medicaid, Medicaid Savings Program (MSP), Low-income Savings (LIS — aka “Extra Help”), SNAP (Supplemental Nutrition Assistance Program, or food stamps), utility assistance, and Lifeline, at the same time!
Our product encodes all of the complex eligibility rules, applications, and submission processes into a single, streamlined enrollment process. A series of “rules engines” allow someone to gather the smallest amount of information needed to determine exactly which programs someone might be eligible for and minimizes the information needed to accurately and completely submit each application on someone’s behalf. Our experienced outreach staff uses this product and calls people over the phone to take them through the process end-to-end.
The technology makes it easier and faster to unlock more cash and savings for the Medicare member, which gives them a better chance of improved health outcomes, and in turn leads to savings for their health insurance plan. For example, research shows that just enrolling seniors in food stamps (SNAP) can drive 15% in annual medical savings. And that’s in addition to the revenue, and decreased burden on clinical teams.
It’s a big challenge for insurance companies to balance short-term financial interests with long-term patient health outcomes, and this opportunity presented a true win-win.
Our partnership with Oscar Health
Today, we’re excited to announce our partnership with Oscar Health. Over the past several weeks, our services have helped Oscar respond to the needs of their most vulnerable members in light of COVID-19. In addition to critical financial resources, Uno and Oscar have been working closely together to go even further in mitigating the largest threats — access to food and prescriptions in their home, and social isolation. Uno is helping members on SNAP (food stamps) take advantage of the new online grocery pilot to use their EBT credit to place online deliveries to their home, and referring those isolated to virtual companionship services — such as Kindness of Strangers.
Take the case of Patricia D., a 73-year-old retired home attendant who is covered for her health insurance through Oscar Medicare Advantage. Patricia lives in the Bronx in a rental apartment which costs her $1,350 per month. She gets $1,250 per month from Social Security. Her work used to help her cover the difference, and her grandson has been helping her out since she retired, but he recently lost his job due to COVID-19. Patricia was already enrolled in SNAP but Uno uncovered that she was also eligible for MSP, LIS, SNAP, EPIC (Elderly Pharmaceutical Insurance Company) and Lifeline — programs that totalled over $10,000 in savings per year. When we shared the news with Patricia in late March, she was completely unaware of these opportunities and was absolutely delighted by the support, especially to find that the programs could help cover > $300 of outstanding medical expenses, and wanted to recommend Oscar to a friend as a result of their experience.
At Uno, we’re on a mission to unlock financial equity so that millions get a chance at the health they deserve. With the economic crisis looming behind this pandemic, this mission stands even more true today, and our goal is to build a truly sustainable way to deliver impact far beyond COVID that will reduce the health disparities we’re seeing play out today.
We’re excited to be on this mission with some amazing investors — including Floodgate, Cowboy Ventures and Meridian Street Capital — and some of the top experts in the industry, including John Loser (former Chief Risk Officer, Oscar), Trent Haywood (former President of BCBS Institute), Pamme Taylor (former VP at WellCare), Jay Bhimani (Head of growth at Patient Ping) and Joe Crobak (former co-CTO of CMS Quality Payment Program).
