Social determinants of health are a focal point of health plan initiatives and funding as they play a significant role in healthcare outcomes and costs. Social determinants encompass many factors beyond the scope of care that health organizations provide, including patients’ socio-economic status (SES) and access to healthy food and housing. Social and environmental conditions are critical to an individual’s health and overall quality of life, accounting for 80% to 90% of health outcomes, whereas medical care only accounts for 10% to 20%. As such, social determinants have a major impact on the burden of the healthcare system, specifically on outcomes and costs. Health plans and systems are therefore using technology-driven initiatives to address social determinants through data collection and sharing.
Unite Us—a maker of care coordination products designed to bridge the gap between clinical care and social services by facilitating cross-sector collaboration and data sharing—has partnered with various health plans and systems to address social determinants of health. Unite Us’ partnership with the Connecticut Hospital Association connects patients to local social service agencies to address issues they face pertaining to housing, food, transportation, employment and more. In return, these collaborations provide health systems and other healthcare organizations with physiological, environmental, and lifestyle-related data about these populations, which ultimately enable better and more personalized treatments. In May 2019, Unite Us partnered with Kaiser Permanente to launch a first-of-its-kind program connecting all Kaiser members to resources addressing social needs. The initiative, called Thrive Local, is a social health network that integrates clinical care with mental health care and community services to provide support for individuals struggling with food insecurity, housing issues and other key health-related social issues.
CVS-Aetna also partnered with Unite Us to build a digital network of social care providers. The Destination: Health platform, created to connect the most at-risk Aetna members with cost-saving social services, is part of CVS-Aetna’s larger “Building Healthier Communities” initiative. Social determinants are related to the high costs associated with chronic disease management, a reason health plans like Aetna are interested in combating these determinants. The cost of care for an individual with three or four chronic illnesses is over 500% greater than for individuals without a chronic illness, and 90% of the U.S.’ $3.3 trillion annual healthcare costs is spent on individuals with chronic ailments. Addressing social determinants may help reduce the prevalence of chronic illnesses in the U.S.
Initiatives to address social determinants have the potential to lower healthcare costs greatly while also improving health outcomes. Health plans and systems are beginning to use data collection tools to connect individuals with necessary social services, and providers are gaining a better understanding of which social determinants most strongly influence health outcomes and costs. However, it is still too soon to accurately assess the impact of existing initiatives. While many health plans and systems are supporting local community-based providers and funding philanthropic initiatives to help vulnerable populations, addressing social determinants of health as an integral part of health plans’ and systems’ core business is still in its early stages. The trend of social determinant-focused partnerships and projects is growing, but it is unclear how integrated into the healthcare system these types of initiatives and programs will ultimately be.