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Payer Collaboration Can Address Social Determinants of Health (Health Payer Intelligence)

Thomas Beaton writes for Health Payer Intelligence about how billions of dollars in medical overspending can be attributed to social determinants of health (SDOH). Beaton notes that “in order to help healthcare providers, public health officials, and community organizations address socioeconomic issues that may negatively impact outcomes, payers must develop a clear understanding of the challenges faced by patients in their daily lives.”

This understanding is beginning to take shape through “partnerships and collaborative projects that leverage existing resources in the community.” The article references a recent report from America’s Health Insurance Plans (AHIP) highlighting specific collaborative initiatives across the country that unite payers and providers with community organizations. “Anthem, for example, has taken on these challenges by launching a partnership with the National Urban League, City of Hope, and Pfizer to improve breast cancer and heart disease care in African American communities nationwide via survey and online modules. The program, Take Action for Health, also promoted emotional wellness through interactive web tools and surveys in these communities as well.”

Through DCHI, Delaware has established five key initiatives to address SDOH, practice transformation, and the move towards a value-based payment system. Through cross-collaboration among all of DCHI’s committees, payers, providers, and community organizations are coming together to help the state reach its goal of being in the top 10 percent of states for healthcare quality and patient experience. To learn more about DCHI’s payment model and the drive towards value-based outcomes, which has a strong foundation in addressing SDOH, please visit the Payment Model Monitoring Committee at https://www.dehealthinnovation.org/.

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