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3 Major Payers Take Action on Social Determinants of Health
Elevance Health, Aetna, and Cigna health plans have launched various social determinants of health initiatives to improve members’ quality of care.
Updated 9/20/22: A previous version of this article included Blue Cross Blue Shield companies as Elevance Health plans. However, these companies are not Elevance Health companies. This has been corrected by moving that section to the bottom of the article.
Major payers Elevance Health (formerly Anthem), Aetna, and Cigna have taken steps to address social determinants of health, demonstrating the broad range of strategies payers have employed and partnerships payers have engaged in order to reduce social determinants of health barriers.
These three payers have the second, third, and fourth highest market shares in the US health insurance marketplace. In 2020, Elevance held 12 percent of the market share, Aetna followed with 11 percent, and Cigna rose to 10 percent.
Collectively, the payers have used their position to launch initiatives that aim to address social determinants of health factors such as housing and food insecurity, poverty, care disparities, and environmental safety.
Their efforts only represent a sliver of payer activity on this issue, but demonstrate the range of social determinants of health strategies being tested in the healthcare industry.
Elevance Health
Elevance Health’s health plans, which include Anthem health plans, have taken a variety of actions to address a host of social determinants of health barriers.
Several Elevance Health plans have launched strategies to address food insecurity.
Anthem Blue Cross and Blue Shield in Georgia partnered with a community-based organization in the Atlanta metro area to establish a facility that would serve the area’s food needs. The facility will be outfitted with a food pantry, restaurant, and community garden. Products will be sold with the Anthem brand.
Anthem Blue Cross and Blue Shield in Missouri partnered with a community-based organization to bring meals to homebound seniors, while also providing social interaction.
Aetna
Aetna CVS Health health plans addressed a variety of issues, including food insecurity, access to mental healthcare, housing, and employment.
Aetna Better Health of Louisiana put $50,000 toward reducing food insecurity in underserved areas. The health plan helped fund the efforts of a local nonprofit that teaches communities about sustainable agricultural practices for urban farming.
In order to improve access to mental healthcare services, Aetna Better Health of Kansas donated $125,000 toward community health organizations that offer mental health and social care services.
A social determinant of health factor that Aetna plans commonly address is housing. CVS Health has partnered with Fresno, Pedcor Investments, R4 Capital, WNC & Associates, Raymond James Tax Credits Funds, and other companies to establish affordable housing units. The payer has funded housing developments in Florida, Louisiana, Tennessee, Washington, DC, and elsewhere.
Employment falls under economic stability, one of the five domains of social determinants of health.
CVS Health opened a Workforce Innovation and Talent Center in Pittsburg, Pennsylvania in order to continue fostering relationships with community leaders and offer employment training for individuals pursuing pharmacy technician, customer service, call center, and retail associate work. The center includes a simulated retail store and a fully functioning restaurant.
Cigna
Cigna’s social determinants of health work is wide-ranging like its competitors.
The payer sought to address environmental safety during summer heat waves by funding members’ transportation to air-conditioned locations. These destinations could be clinical sites, such as doctor offices and pharmacies, or public areas like libraries and senior centers.
Cigna also sought to address food insecurity through the Cigna Foundation. The Cigna Foundation donated $2.2 million toward 16 schools that have large populations of low-income students. The funding will be used in part to stock school food pantries and allow schools to offer weekend food kits.
In addition to providing help with food security, the 16 schools can use the Cigna Foundation funding to facilitate mental healthcare for students. For example, the funds will go toward training teachers on how to introduce mindfulness practices in their classes along with inclusion and social-emotional learning.
The Cigna Foundation also accepted applications for the Education and Workforce Development grant program, which aimed to offer opportunities to students across the academic range—from pre-kindergarten to post-secondary—who might face social determinants of health barriers.
Other major health plans—such as Blue Shield of California and Blue Cross and Blue Shield of Illinois—donated to organizations that were already on the ground locally addressing food insecurity.
Companies also took steps to address health equity. For example, Blue Shield of California invested $150,000 into the community of San Joaquin Valley to support health equity initiatives. The initiatives met needs such as hands-on job training and housing services.
Blue Cross Blue Shield of Michigan donated toward permanent housing projects to address racial and economic disparities. The housing projects incorporate intensive case management and health and welfare services.
Health plans sought to address care disparities in maternal healthcare, an area of healthcare that is deeply affected by social determinants of health barriers that often result in health inequities.
Blue Cross and Blue Shield of Illinois offered $350,000 in grants to six community-based organizations that serve mothers in Chicago’s south- and west-side neighborhoods to improve patient outcomes.
Blue Cross and Blue Shield of Minnesota and Blue Plus sought to improve information about how food insecurity impacts mothers and infants. The health plan partnered with a food bank and a market platform to research how access to seven months of nutrition benefits and services affected the health of Black and Indigenous pregnant individuals.
Health plans also sought to address poverty by alleviating financial social determinants of health barriers to healthcare.
Blue Cross and Blue Shield of Illinois invested $20,000 in a community network of churches, businesses, and volunteers that fights poverty. The payer is working with the network to connect impoverished members and their communities with resources.
Blue Cross and Blue Shield of Montana put $50,000 toward a Healthy Kids, Healthy Families grant that sought to support children who face intergenerational poverty. The investment goes into nonprofits that create sustainable opportunities for connecting children and their families with nutrition, physical activity, suicide prevention, disease prevention and management, and substance abuse prevention.