3 Ways to Assess ROI on Social Determinants of Health Programs

Payers can leverage beneficiary surveys, opportunities to share lessons learned, and social services referral platform data in order to assess the return on investment for social determinants of health (SDOH) programs, according to a NORC at the University of Chicago (NORC) case study report commissioned by Better Medicare Alliance.

“In recent years, Medicare Advantage plans have taken significant steps to address the SDOH needs of their beneficiaries. In doing so, plans have often formed innovative partnerships with providers, technology companies, and community-based organizations to advance their efforts,” Dianne Munevar, senior director of health care strategy at NORC, said in the accompanying press release. 

“As these case studies demonstrate, many of these interventions are now proving successful for beneficiaries – providing lessons for policymakers that can be applied throughout the health care community.”

Some Medicare Advantage plans rely on beneficiary surveys to assess social determinants of health programs’ returns on investment.

For example, SummaCare, a health plan offered by the healthcare system Summa Health serving over 22,000 Medicare members in northern Ohio, used a survey to evaluate the outcomes of its companionship program.

Payers often use companionship programs to help beneficiaries complete household chores or to reduce seniors’ loneliness.

SummaCare worked in partnership with a Papa Inc, an organization that connects seniors with young adults who can support seniors in their day-to-day practical and social needs.

SummaCare’s partner handled the outcomes assessment. Papa issued surveys to program participants at the beginning and end of the pilot program. Papa developed the survey questions from the UCLA Loneliness Scale as well as CDC Healthy Days measures, a common metric for payers in their social determinants of health programs.

By the end of the program, program participants reported that their loneliness had been more than halved. Their self-reported unhealthy days also dropped by two days.

Moreover, beneficiaries’ outlook on the health plan itself was more positive. The payer’s net promoter score rose among individuals who participated in the Papa program.

Surveys can also be useful to assess social determinants of health strategies among health plans. Health plans can use data on other payers’ strategies around social determinants of health to assess their own approaches.

The SNP Alliance, a group that is comprised of Medicare Advantage special needs plans and Medicare-Medicaid managed care organizations, surveys its payer members to understand their approach to social determinants of health. The SNP Alliance has been tracking social determinants of health interventions among payers for five years.

“We’ve seen more sophistication over the years about SDOH as health plans reported SDOH efforts and responded to our annual survey questions,” said Deborah Paone, MHSA Performance Evaluation Lead and Policy Consultant. 

“We see greater understanding and capability to find and use a variety of data sources for identifying and addressing SDOH issues in their special needs and dually eligible populations. We see greater ability to stratify or categorize different risk issues within their enrolled membership.”

According to the SNP Alliance 2021 report, 60 percent of members are using their social determinants of health data to change their model of care and services, 55 percent are leveraging the data for member outreach, care management strategies, risk stratification, or member education.

The SNP Alliance health plans’ partnerships to address food insecurity rose 67 percent from 2020 to 2021 and partnerships around language or health literacy and social support needs each grew by 47 percent.

In addition to the survey, the organization also hosts a conference which enables payers to share best practices with each other.

“We’ve made SDOH a key focus of our Alliance; undertaking numerous efforts to identify and share best practices and lessons learned across our membership,” Cheryl Phillips, MD, president and chief executive officer of SNP Alliance, added in the press release. 

“Our annual survey and our conferences provide us a window into our member health plans’ SDOH strategies, allowing us to monitor progress and refine our approaches.”

Additionally, payers can partner with vendors that will track results for them, providing strong return on investment data for social determinants of health programs. Referral platforms for community services can show when a provider initiated a referral, how long it took to complete the referral, which organizations are receiving members by referrals, and more.

As health insurers work towards better solutions for their members' social determinants of health needs, they may continue to lean on survey results, lesson-sharing among health plans, and referral platform data to assess the outcomes.