What Healthcare Members Want: Key Lessons from RISE SDoH Summit Panelists

  • May 22, 2025
  • Blog Post
  • Kathleen Ellmore

When it comes to improving healthcare systems, there’s no substitute for listening to the people living within them. A recent panel discussion at the RISE SDoH Summit brought together five individuals - all with different healthcare coverage, challenges, and stories - to share their experiences navigating care, insurance, and the everyday barriers that shape their health.

Here are five key themes we took away - and how health plans can respond.

1. Choosing a Provider Is Often Based on Trust and Trial-and-Error

Several panelists described struggling to find the right care. For many, referrals from friends and personal experimentation were more reliable than provider directories or online tools.

How Health Plans Can Address This:

  • Improve provider directories with up-to-date availability and patient reviews.
  • Offer personalized care navigation or concierge services.
  • Simplify cost information and make out-of-pocket estimates clear upfront.
  • Encourage peer support programs that allow members to share trusted experiences.
2. Transportation Can Make or Break Access to Care

For patients without personal transportation, the availability and reliability of services like Medicaid transport or public buses can be the difference between attending an appointment and missing it.

How Health Plans Can Address This:

  • Proactively educate members about available transportation benefits.
  • Partner with rideshare services to supplement non-emergency medical transport.
  • Track missed appointments by geography to identify high-barrier areas.
  • Provide flexible scheduling for members with transport delays.
3. Provider Shortages Create Gaps in Access to Care

Post-COVID, panelists reported longer wait times and more difficulty getting appointments. Some have had to resort to in-person drop-ins just to be seen.

How Health Plans Can Address This:

  • Monitor and enforce timely access standards for network providers.
  • Add or expand telehealth options for faster access to care.
  • Empower member services teams to proactively assist with scheduling.
  • Offer a waitlist notification system for earlier appointment openings.
4. Neighborhoods Shape Social Determinants of Health

Panelists emphasized how deeply zip code impacts health - from access to fresh food to neighborhood safety. Choosing between prescriptions and groceries was a common reality. While tools like GoodRx help, panelists called for broader, more systemic support.

How Health Plans Can Address This:

  • Leverage local data to identify high-need areas and direct targeted resources.
  • Screen for food insecurity and other social needs during intake and care transitions.
  • Partner with community organizations like food banks, mobile markets, and housing groups.
  • Invest in local solutions, including community health workers and neighborhood wellness hubs.
  • Offer education on food benefits and meal planning to help members stretch limited resources.
5. Benefits Navigation Is a Challenge

Even panelists with healthcare experience reported confusion with insurance processes and understanding how to use their benefits.

How Health Plans Can Address This:

  • Assign dedicated care coordinators or navigators to high-need members.
  • Simplify communications - avoid jargon and use visuals or multilingual materials.
  • Provide annual benefit walkthroughs with real-life scenarios.
  • Strengthen collaboration with eligibility offices to reduce churn and re-enrollment barriers.

The panelists reminded us that healthcare is not experienced in isolation - it’s shaped by transportation, food, housing, trust, and time. Their stories challenge health plans to go beyond traditional care and think holistically about what it means to be well.

Listening is just the first step. The next is acting - with compassion, clarity, and systems that truly serve.

Kathleen Ellmore

Ms. Ellmore is one of the earliest pioneers in bringing the best of consumer marketing and data driven methodologies to healthcare. Instead of getting you to eat when you are not hungry and buy things you don’t need, we can finally use the same strategies to instead change the health equation in America. Kathleen previously led the Consumer Engagement consulting practice for Welltok (formerly Silverlink) for 12 years, leveraging its data repository of over a billion consumer health interactions, the best of behavioral economics, and the latest in clinical research, to create evidenced-based communications on what works to drive consumer healthcare behavior yielding better outcomes and lower costs. She is often quoted in the trade and national press and is a regular speaker on the national stage, having spent the first twenty years of her career in brand marketing at leading consumer marketing organizations, including General Mills and P&G. Additionally, she was a Vice President at Digitas, a leading direct marketing firm. Recently she was selected as Consultant Member of the first ever FDA’s Patient Engagement Advisory Committee.