Payer Gives Community-Based Social Determinants of Health Support

Updated 6/30/21: Humana's Bold Goal strategy led to a 6.8 percent decrease in the number of unhealthy days for San Antonio members. A previous version listed 8.6 percent as the figure.

Humana has partnered with a technology platform and a group of community-based organizations to address social determinants of health for Medicare Advantage members in San Antonio, Texas.

Alamo Area Community Network (AACN), an alliance of community-based organizations, offers resources and programs that help residents access food, childcare, transportation, housing and financial support, and other social determinants of health.

Through this partnership, Humana will grant its Medicare Advantage members access to local social determinants of health supports.

“It’s not enough to just support our community partners in their work. In order to create real change, we, as a community, are rethinking the way we approach social health and clinical health,” Bill White, president of Humana Texas Medicare, said in the press release.

“By joining the Alamo Area Community Network, we are able to integrate the way we address health-related social needs into the same system as our San Antonio community partners.”

The partnership will be a fusion of healthcare stakeholders from multiple sectors including providers, payers, nonprofit organizations, and government agencies.

Using a Signify Health technology platform, AACN’s community-based organizations can communicate about and keep track of Humana members’ needs. For example, community-based organizations can submit electronic referrals to one another on behalf of patients, speeding up the referral process.

The partnership will give members quicker access to resources and assistance through their communities, rather than going through the payer itself.

The Kronkosky Charitable Foundation assembled AACN in September 2020 to improve the overall health and wellbeing of its communities and provide accessible services for members facing social determinants of health.

“True collaboration across such a broad spectrum of organizations – social service providers, healthcare providers, philanthropies, government agencies, health plans – is only possible through trust,” said Cara Magrane, director of initiatives and partnerships for the Kronkosky Charitable Foundation.

Humana members will also have access to social care coordinators who are available to help with any further questions they may have regarding their health needs.

San Antonio is a part of Humana’s Bold Goal strategy, which focuses on decreasing social determinants of health barriers for Medicare Advantage members. Since Bold Goal established community-wide initiatives to accomplish their social determinants of health goal, the number of unhealthy days for Medicare Advantage members in San Antonio has decreased by 6.8 percent. Humana’s new partnership seeks to further this progress.

Payers who partner with community-based organizations may see greater success in addressing their members’ social determinants of health needs.

Payer experts have asserted that in order to pursue effective whole person care, payers must collaborate closely with community-based organizations. Community-based organizations need to be attuned to the particular needs of the local population in order to serve them. As a result, they can be trusted and knowledgeable partners.

Blue Cross and Blue Shield of Kansas City (Blue KC) partnered with the social needs referral network, a group of community-based organizations that work to address social determinants of health in Kansas City, Missouri. If a Blue KC member was facing a social determinant of health barrier, the provider could refer the member to one of the community-based organizations in the network.

The payer also launched a digital platform that would help Blue KC employees and providers keep track of patient data and find community-based organizations that meet patients’ needs.

Other payers like Blue Cross and Blue Shield of Illinois (BCBSIL) have collaborated with community-based organizations to help members address and overcome care disparities. BCBSIL allocated $350,000 to six community-based organizations in Chicago that provide education and support to new mothers, aiming to reduce maternal care disparities.