17 Jul The Rise of Social Determinants of Health in Payer Arena

Late last month, AHIP hosted its 2019 Expo and one of the key themes of the event was the rise of social determinants of health (SDOH) – specifically the need for payers to focus on “whole person care,” as well as to address social and economic barriers to better serve vulnerable populations.

Mark Farrah Associates (MFA), a publisher of health plan market data, offered these insights into what was covered with regards to SDOH and payers at the conference. MFA also discussed how SDOH have long been linked to patient health, but not necessarily intertwined with health insurance benefits – though this is rapidly changing.

At the conference, co-presenters from L.A. Care Plan and UPMC Health Plan discussed special housing programs for homeless health plan members which have proven to lower per member per month (PMPM) healthcare costs.

AHIP also announced the launch of a new initiative to overcome social determinants challenges called Project Link, which helps payers to tackle social barriers such as transportation access, safe housing, maintaining a healthy diet, and other non-medical factors that contribute over 70 percent to an individual’s health and wellbeing.

In addition, in May we highlighted how UnitedHealthcare and the American Medical Association (AMA) partnered to help standardize how data is collected, processed and integrated with regards to critical social and environmental factors that contribute to patient well-being.

Through this collaboration, UnitedHealthcare and the AMA are supporting the creation of nearly two dozen new ICD-10 codes related to SDOH. By combining traditional medical data with self-reported SDOH data, the codes trigger referrals to social and government services to address people’s unique needs, connecting them directly to local and national resources in their communities.

With the right data management solutions, payers can better align claims and clinical systems to drive new SDOH and population health initiatives. From Provider Dashboards to Business Intelligence tools to longitudinal patient charts, IMAT’s Health Data Analytic capabilities can transform population health and risk management for payers.

To learn more about how payers can best harness their data for improved analytics, interoperability and outcomes, please click here.