Recent reports show that up to 80% of payers are integrating social determinants of health (SDOH) into their member programs. To address this market focus, HGS recently sponsored a webinar on Best Practices in Addressing Social Determinants of Health Issues Impacting Highest-Need Populations with AHIP. This well-attended event deserved a follow-up session as there were so many great questions from the attendees. On January 15, HGS shared more essential SDOH thought leadership from our experts Mary Jane Konstantin, SVP and Head of Business, HGS Population Health Management Solutions, and Tara Page-Haddock, Strategic Product Manager, HGS Population Health Management Solutions.
Mary Jane kicked off the session with an overview of SDOH, including the importance of focus on the individual level. We level set attendee focus with a poll, “Which best describes how my organization approaches social determinants?” In sum, 32% of our attendee organizations aim to “Address social barriers, with no formal program,” while 27% do, in fact, have a program to address barriers at the patient level. A front-line focus of “Programs to address social issues within my community” was the response for 23% of our attendees, with 18% “Routinely assessing for social barriers at the patient level.”
We polled the audience on “Does your program have a systematic approach for face-to-face outreach,” and 59% of attending organizations do not have this approach. This assessment enabled Mary Jane to elaborate on the value of connecting face-to-face with SDoH outreach. She shared the team members—from peer counselors to community health workers, who can make a significant impact on outcomes with a targeted approach.
Following the webinar, our thought leaders answered some pressing questions:
Question: Can you talk about how a resource list does play a role in SDoH programs?
Mary Jane: In our experience, it's important to make sure that there is some ongoing effort to update the resource list and make sure it's still active. I think through issues like housing, we can help with not only housing grants, but also paying for utilities. You need to know what’s available in the local community.
I do want to stress that just giving someone a referral generally isn't enough. You've got to make sure that the member stays well connected with the resource. So as you're thinking through your outreach, make sure that you've made some accommodations for those kinds of services. Tara, anything to add on this topic?
Tara: I will add that it’s key to consider the cultural centers and the retirement centers and the social networking that exists within the member’s community. Our work is often detective work, as we search for the availability of often previously unknown resources.
Question: Can you talk about how you can help with SDoH transportation issues?
Tara: Today, there are a lot of partnerships with Lyft and Uber happening in the communities, and it’s really been really neat to see. I worked with a member in a past program who had a walker, and she walked to the bus and grocery store. She needed the bus to get to the pharmacy and her appointments. Her issue presented with the fact that she couldn’t get to the bus and she couldn't get a ride to those appointments. Add to that the fact that her walker wheels were only covered every three months for replacements. This is a good case of a transportation issue. It was about getting her durable medical equipment approved outside of the normal parameters, because her usage of her equipment was so much greater than the average individual who had a walker. This is how transportation can be a key element in understanding.
This can be one of the easiest things to solve for—it’s essential to look at access to transportation and what those benefits are. In healthcare, we often assume members are reading their benefits, yet sometimes it's just about acknowledging that they have the benefits and helping the member access them.
I don't think we're saying that transportation is always the key to improve clinical outcomes. But I believe that when transportation presents as a barrier to care and accessing lifestyle life needs, there’s an opportunity there to make that Improvement.
Lifestyles, locations, and surroundings can all have an impact on an individual’s health. Focusing Social Determinants of Health on the individual level leads to reductions in cost of care through driving engagement, outcomes, and results.