UnitedHealthcare and the American Medical Association on April 2 announced they’re collaborating on a project aimed at better identifying and addressing social determinants of health (SDOH).
According to a joint statement, the initiative will build on work started by UnitedHealthcare, which previously developed a data model focused on standardizing the compilation and processing of SDOH-related information. Physicians and administrators currently use a system of ICD-10 codes to classify and record all diagnoses, symptoms and treatments; in announcing this partnership, UnitedHealthcare and the AMA are agreeing to create nearly two dozen new codes related to SDOH.
“UnitedHealthcare and the AMA share a common goal of expanding the healthcare system’s perspective to consider the whole person—not just medical care—by placing as much emphasis on people’s social needs as on their clinical needs,” Bill Hagan, president of clinical services for UnitedHealthcare, said in the statement. “By working together to leverage data, technology and the incredible expertise of our network physicians, we can more effectively address the social factors that limit access to healthcare.”
Almost 80 percent of what influences a person’s health has nothing to do with medicine but rather with social factors like food, housing, transportation and financial wellbeing. A survey conducted by medical billing service Waystar last December found 68 percent of respondents reported at least one SDOH, with more than half having high to moderate SDOH risk in at least one category.
UnitedHealthcare and the AMA are combining traditional medical data with self-reported SDOH information to create their new set of ICD-10 codes, which will trigger tailored referrals to social and government services to address people’s individual needs. UnitedHealthcare claims to already have made more than 700,000 social-service referrals for people enrolled in its Medicare Advantage plans since 2017, adding up to an imputed market value of more than $250 million.
According to their statement, the two organizations will consider a variety of SDOH, including but not limited to education, employment, food, housing and access to transportation. Waystar found the most common SDOH issues reported across its payer classes related to financial security and social isolation, while food insecurity was found to be the least common issue among the insured and health literacy was the lowest self-reported issue among Medicare and Medicaid enrollees.
“The AMA is excited to work with UnitedHealthcare through the continuing efforts of our Integrated Health Model Initiative (IHMI) to foster collaboration around innovative data and technology-driven processes for incorporating social determinants of health into routine medical care,” Tom Giannulli, chief medical information officer for the IHMI, said. “The collaboration reinforces the importance of social and environmental factors in patient care, and will shape IHMI’s efforts to support clinical decisions with useful and valid data to achieve broad improvements in health and greater health equity.”
The AMA announced the launch of its first IHMI project—a data model designed to better manage blood pressure information—in February.
“The collaboration between UnitedHealthcare and the AMA illustrates a growing recognition of the partnerships that are essential to the success of patient-centric healthcare,” the two organizations said in their statement. “With a consistent set of standardized data, healthcare organizations can tap into local and national resources to connect people to social and government services.”
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.