Q: Is there a guiding principle in the work you do?

Member Spotlights allow us to have a casual conversation with an Academy Member and provide a different perspective on their current work and why they feel it is important. This month, we spoke with Merrill Friedman, who leads the Disability Policy Engagement team and advocacy strategy for Anthem, a leading health benefits company serving more than 74 million people nationwide through its affiliates. 

Q: Is there a guiding principle in the work you do?

The disability communities we serve include all disabilities—physical disabilities, intellectual and developmental disabilities, mental health conditions, and substance use disorders. One of the mainstays of our work at Anthem is to ensure that people with disabilities are actively engaged in any and all conversations about their lives. Policy shouldn’t be made about people; it should be made with people. We are constantly engaged in outreach efforts to ensure that our conversations always include people, and we are working together toward independent living and self-determination for all.

Q: What are the most successful outreach methods you use?

We collaborate with national associations who are not just about people with disabilities, but are organizations comprised of and led by people with disabilities, such as the National Council on Independent Living or the Autistic Self-Advocacy Network. At Anthem, when we are working on a brief or solution for or about autistic people, we engage with them to seek feedback.

We also work to find affiliates in the states working on the local level. A lot of the services and supports people with disabilities or older adults rely on are delivered by community or faith based organizations.  We build partnerships and provider relationships with organizations and support them in their efforts to meet the needs and preferences of people with disabilities and older adults – outside of the clinical setting – so they can live successfully in the community. These local organizations address many of the health influencers – employment, transportation, food insecurity, housing, education, and social isolation – that don’t require a doctor visit but are provided by direct support professionals and community organizations.

For example, our Anthem Indiana Medicaid plan collaborates with the City of Indianapolis Partners in Housing and Adult and Child Health (CMHC) for a program called Blue Triangle, which is based on the Housing First philosophy that supports people with mental health conditions experiencing homelessness. In Texas, we partnered with TIRR Memorial and the Houston Mayor’s Office on a project called the Houston Livable Communities Initiative, which addresses livability and access for people with disabilities and older adults in their communities.

Q: What changes are you experiencing in your efforts?

The good news is the increasing national focus on health influencers. The greater conversation about health care now includes the whole person; housing, food insecurity, people working more than one job, day care needs, and livable wages. All people need a place to live, access to affordable and nutritious food, transportation, and people they choose to be in their lives. We’re completely missing the boat if we say we’re going to change the face of health care by just making sure we have hospitals and clinics. We have to be changing the acceptance of diversity in all we do, so that companies and schools are talking about and building inclusive environments – cultures for people with disabilities, people who identify as LGBTQ, people of color. We need to have these conversations and engage people in that change.

Q: Is it unusual for an insurance company to be addressing social determinants of health?

About 85% of people’s health outcomes are based on how and where they live. We want to know: Do you have a job, do you have stable housing, are you experiencing food insecurity, do you have people and friends in your life? Loneliness kills more people than heart disease. If someone is experiencing homelessness, they may not be able to focus on a well-child visit or getting their colonoscopy because it’s not their priority. We have to look beyond whether someone is going to see their PCP or specialist.  As a company, Anthem is focusing on addressing social determinants of health through our advocacy, policy, and health plan and foundation activities.

Q: How do individuals access this kind of support through Anthem?

The services and supports that Anthem provides depends on where  an individual is enrolled; if they’re enrolled in a commercial plan it will look completely different from a Medicaid program or a waiver program. Within Medicaid, for those who are eligible, there is a full structure of care coordination services and supports that are part of the program requirements and for which we track outcomes. For example, Anthem members have access to a service coordinator or may be assigned a care manager who can provide them with additional resources based on their individual needs and what is available in their community.

Q:  Many Members of the Academy strive to provide reliable information for policy recommendations; how does the kind of work they do support your work?

Data is very important when we want to make a recommendation to states or federal partners to influence what is covered. For instance, if we say people who self-direct their services have better health outcomes, what does the data show? Well, it shows that when someone can choose their PCP or direct support professionals, it leads to a better relationship, and that a relationship with longevity leads to better quality of life and wellbeing along with fewer emergency room visits, decreased injuries, and  an increase in employment and other activities that are meaningful to the person. Or if we say non-medical emergency transportation should be covered, there’s data that shows ensuring transportation to medical appointments and other important activities increases positive health outcomes. Prevention and community inclusion works!

More about Merrill Friedman

At Anthem, Merrill Friedman works collaboratively with consumers, advocates, and stakeholders to ensure that the diverse interests and preferences of those they serve – older adults, individuals with disabilities, and children, adolescents and young adults involved in the child welfare and juvenile justice programs – are embedded in their efforts. Previously, Ms. Friedman was interim director at a nonprofit foster care agency serving at-risk children and adolescents. She also served as president and chief executive officer of a private organization that owned and operated residential treatment facilities, group homes, and home and community-based services in several states for adolescents with mental health conditions, substance use disorders, and intellectual disabilities.

Ms. Friedman has served on numerous national boards and commissions. She was appointed by President Barack Obama to the President’s Committee for People with Intellectual Disabilities. She serves on the board of directors for Family Voices and is a member of the National Association of States United for Aging and Disabilities (NASUAD) Managed Long-Term Services and Supports (MLTSS) Institute Advisory Board. She has been a member of the Academy since 2017.

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