Payers Kick-Start 2020 Social Determinants of Health Strategies

December 27, 2019 - 2019 was a big year for payers in pursuit of social determinants of health. Many payers invested resources and funds toward addressing the challenges their members faced in accessing quality healthcare.

As the new year approaches, a couple of payers have announced new initiatives, grants, and products to start out 2020 with a social determinants of health focus.

UPMC Health Plan’s Social Impact Initiative

Only a couple weeks before the new year, University of Pittsburgh Medical Center (UPMC) Health Plan announced a social determinants of health initiative called UPMC Social Impact.

“The goal of UPMC Social Impact is to help meet the health, socioeconomic, and environmental needs of UPMC Health Plan members and the communities we serve,” said John Lovelace, president of government programs at UPMC Health Plan. “The initiative will create new social responsibility programs and expand upon our existing programs to positively impact the health and wellbeing of our members, employees, and the neighborhoods where we live and work.”

READ MORE: Payer Philanthropy Won’t Improve Social Determinants of Health

UPMC Health Plan’s focus is on efforts that will have a direct, measurable impact on social determinants of health.

For example, the payer will invest in stable housing to decrease homelessness by investing in affordable housing. It will start programs that address social determinants such as employment and will work to ease access to healthcare for underserved and vulnerable populations.

The payer will also address transportation needs, coordination of behavioral and mental healthcare, access to care and improved quality of care for LGBTQIA communities and across its programs, child wellness programming, and preventive care for those who are susceptible to social isolation, particularly in the senior population with dementia.

UPMC was particularly focused on value-based care alternative payment models in 2019, specifically through their value-based contract with Biogen just last month and their deal with AstraZeneca in January.

BCBSRI’s Investment in Affordable Housing

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Blue Cross Blue Shield Rhode Island (BCBSRI) recently announced that it will be investing $200,000 in grant funding in five organizations that work to improve access to affordable housing. These organizations both heighten societal awareness around housing stability issues and actively enable at-risk communities to access stable housing.

This is a new trajectory for BCBSRI in terms of philanthropically supporting affordable housing. The payer’s RI Life Index prompted this decision. This year’s RI Life Index elucidated the challenges Rhode Islanders face when it comes to stable, affordable housing. 

 “I’m excited that as a first step in activating the findings of the RI Life Index we are making investments that address the critical role of safe and affordable housing on the overall health and well-being of Rhode Islanders,” said BCBSRI president and chief executive officer Kim Keck. “Extensive research shows that housing is a crucial factor influencing not only health outcomes, but also, significantly, school performance. Our company is proud to support organizations making a difference for Rhode Island families by addressing this critical need.”

The payer also started offering products based on the RI Life Index results, including healthcare transportation and meal delivery following discharge, which is interesting to note in light of recent criticism regarding payer philanthropy.

In response, BCBSRI started these grants which will act as a segue to the 2020 BlueAngel Community Health Grant Program (BACHG), a seventeen-year-old annual grant program to be awarded early on in the new year.

READ MORE: Cigna, Humana Expand MA Plans to Cover Social Determinants of Health

Cigna’s MDLIVE Service

Regardless of geographic location, behavioral healthcare is notoriously hard to come by, though some communities suffer a greater dearth of resources than others. In the fourth episode of Xtelligent Healthcare Media’s Healthcare Strategies podcast, attorney Christian Puff gave voice to this challenging truth. Stigmas, lack of knowledge, and lack of resources can often stand in the way of finding treatment.

Cigna’s MDLIVE seeks to solve access to behavioral healthcare barriers through virtual care.

Any Cigna member enrolled in an employer sponsored health plan can schedule an online appointment. They can attend their appointment with one of Cigna’s network of over 18,000 licensed virtual health counselors or psychiatrists via video or phone.

The behavioral healthcare providers are equipped and licensed to not only make mental and behavioral health diagnoses but also to prescribe treatments including medications.

Consultations also have the same cost-sharing rate as a visit to the provider’s office.

"Providing personalized and affordable health solutions when and where our customers' need them and ensuring quality treatment are our top priorities," said Julie McCarter, vice president of product solutions at Cigna. "As the demand for mental health professionals continues to grow, it can be challenging for customers to have access to care at the times they need it most. Working together with MDLIVE, we are delivering increased connectivity to help our customers live their healthiest and most vibrant lives."

These three payers represent just a couple of ways in which payers are starting out the new year tackling social determinants of health head-on, through new initiatives, investments, and products.