UnitedHealthcare Leverages Data to Address Medicare Advantage Beneficiaries Social Determinants of Health

Overview

Social determinants of health are the conditions in which people live, work, and age that shape the conditions of daily life and contribute to health status.1 They include factors such as income, literacy, access to health services, and the social and physical environment.2 Increasingly health plans and providers are partnering with community-based organizations and private companies to address social and economic barriers to care that can include the high cost of care, unsafe housing, food insecurity, and a lack of access to social services and supports. Medicare Advantage health plans are increasingly developing innovative ways to address social barriers to care to improve patients’ quality of life and health outcomes.

The Centers for Medicare & Medicaid Services (CMS) and the Bipartisan Budget Act (BBA) have provided Medicare Advantage health plans with benefit flexibilities to better integrate medical and non-medical care, particularly for chronically ill beneficiaries.3 4 5 However, health care stakeholders still lack comprehensive data to measure the impact of social risk factors on the cost and quality of care. UnitedHealthcare (UHC) is working address this challenge through a national initiative to capture, code, and refer beneficiaries to social services. Standardizing the collection of social determinants of health data will provide more information to policymakers, payers and providers to better meet patient’s needs.