National Health Insurer Association Launches Initiative to Address Social Barriers to Health
In a first-ever nationwide move, on Thursday, June 20, America’s Health Insurance Plans (AHIP), the Washington, D.C.-based national trade association representing the health insurance industry, announced during its annual AHIP Institute being held at the Music City Center convention center in downtown Nashville, that it was launching a new initiative aimed at addressing the social barriers to health.
The initiative, known as Project Link, according to AHIP officials, “will bring together health insurance providers from different markets and geographies to address an array of issues impacting all Americans, from housing to healthy eating to transportation. It will establish clear, collective strategies and goals for insurance providers, ensuring new programs addressing social determinants of health are scalable, sustainable, and measurable in improving health and affordability for everyone. Using Project Link as our foundation,” a press release published Thursday morning noted, “AHIP will develop research and policy agendas at both the state and federal level to improve the health, well-being, and financial stability for consumers, patients, and taxpayers.”
The Project Link announcement was revealed in a press release published online and in a press briefing held at the convention center on Thursday morning.
“We all have a responsibility to create social and physical environments that promote better health for all Americans, Matt Eyles, president and CEO of AHIP, said in a statement contained in the press release. “Project Link solves for this disconnect, bringing us together with a collective vision for enhancing quality of life, improving community health and reduce long-term costs.”
Eyles, in addressing assembled members of the press on Thursday morning in the Press Room at the convention center, said, “I’d like to begin by sharing a brief personal story that goes back to the 1990s. During that time period, my wife and I moved from Washington, D.C. to Indianapolis, and she began working for a Medicaid managed care organization serving an inner-city population there. One of the things that her health plan did was to arrange transportation for members to get to their medical appointments and to access pharmacies. Her health plan also addressed some issues around housing. I wasn’t aware of the term ‘social determinants of health’ at the time, but [hearing about those activities] really set something off in me. And ten years later, when I joined Coventry Healthcare, I worked closely with Ken Burdick, now CEO of WellCare; he was running the government programs there, and had a passionate commitment to addressing those issues. Finally, when I got to AHIP, working with our board of directors, focusing on the drivers of change in healthcare, we identified six at the time, and went to the board and had a conversation, and David Cordani of Cigna said, ‘I think we’re missing a very important driver, the social determinants of health. And from that time forward, a couple of years ago, we made a commitment to addressing the social determinants of health. You all know the statistics about how much of health is determined by the social environment in which you live.”
And that, Eyles said, speaks to the origins of Project Link. Meanwhile, he noted of this year’s annual conference, “Here at the Institute, we have almost 20 separate sessions addressing the SDOH in some way, shape, or form. From David Cordani to Ken Frazier [CEO] of Merck, and the panels afterwards yesterday, you could tell what an important issue we think this is. So we’re so pleased to announce Project Link.”
Joining Eyles in speaking to reporters were Rashi Venkataraman, executive director of prevention and population health at AHIP; Ghita Worcester, senior vice president for public affairs and chief marketing officer, at the Minneapolis-based UCare health plan; and Robin Caruso, chief togetherness officer at CareMore Health, a Cerritos, California-based subsidiary of the Indianapolis-based Anthem Health that provides an integrated health plan and care delivery system for Medicare and Medicaid patients.
Speaking of CareMore’s Togetherness Program, which is aimed at reducing the social isolation of seniors, Caruso said, “A few years ago, our president, Dr. [Sachin] Jain, came to me, about our new disease management program. And when he said loneliness and isolation was the program, my heart leapt. You’re more likely to die of loneliness than obesity, and when I heard that statistic, that really brought it home. It’s like smoking 15 cigarettes a day.” The top three goals of the Togetherness Program, she said, are to get the plan’s Medicare Advantage (MA) members connected to healthcare; to refer them to the appropriate needed resources, whether food, transportation, or community (such as senior center activities); and to get the MA plan members to exercise.
UCare’s Worcester highlighted two groundbreaking programs that have seen successes in Minnesota. The first is the health plan’s Mobile Market, which involved the transformation of two used city buses into grocery stores on wheels, which provide access for poor people (whether UCare plan members or not) to fresh fruits and vegetables and other healthy foods, in concert with subsidies and purchase supports. The second is a program called Circles of Health and Well-being, a program targeted specifically at supporting Medicaid plan members in the southern Minnesota community of Faribault. Those members are Somali women who had no familiarity with the U.S. healthcare system, and who have had the opportunity to learn how the system works and how to appropriately access primary and preventive care, and who also have been taught about nutrition and healthy cooking. Both programs have proven to be highly successful, she noted, and will be expanded over time.
Responding to a question from Healthcare Innovation about what the landscape around innovation around the social determinants of health might look like a few years from now, AHIP’s Venkataraman said, “I don’t think anyone can do this work in a silo. So when we were spending time coming up with a name for this, the word ‘link’ made sense. You have your membership and now you’re being linked to healthcare, and now to social services. No one sector will be able to solve housing issues, or food insecurity, or transportation issues; everyone will have to come together. And taking any one of these issues on really quires everyone to come together. So providers have a role, hospitals, have a role; and affordability over time and sustainability. You’re seeing a lot of interest in this.”
And what about the need for payers and providers to collaborate extensively to make overall progress in this area? “Yes, you absolutely need that link to direct patient care,” Venkataraman said. “The clinical care coordinators, whether social workers or nurses, will be on the front line in addressing some of these needs. And it’s great for physicians and the AMA coming up with ideas about Z codes, etc.,” to create pathways for documenting into the electronic health record SDOH-related data. “What’s challenging,” she said, “is that these are hard conversations for clinicians to have with patients. And in an annual physical exam, you have only so much time for physicians to go through issues, and a conversation about, do you have food in your fridge? Are you in a safe neighborhood? Those are much more difficult conversations.”
Indeed, Venkataraman said, “Whether it’s a doctor, nurse, different people can have those conversations, but making the info you get from those conversations actionable, for next steps—in the next two years, it will be building up those connections. So Matt is food-insecure, we need to get him to a food pantry. And it would be great if the food pantry then alerted you. That’s the feedback loop that we really need to invest in. Screenings and coding are great from a data perspective. But if you ask the question and you’re not referring out, that’s creating a different problem. And what you’ll hear in our sessions today is that health plans are piloting small, to make sure they create that full circle.”
