Humana Issues Brief Detailing Social Determinants of Health Initiatives
Brief details for payers, providers, and policymakers have taken varying approaches to SDoH initiatives.
April 27, 2022 – Humana has a public commitment to whole-person health and has invested in platforms to understand and address social determinants of health. Through their Social Determinants of Health
Data Issue Brief, Humana addressed the various approaches that policymakers, providers, and payers have taken regarding data collection and initiatives related to SDoH.
CMS Promoting SDoH Data Collection
One of the biggest areas that the brief addresses is the political and regulatory landscape surrounding social determinants of health. Namely, how the Centers for Medicare and Medicaid Services (CMS), is promoting data collection.
CMS is using Medicare Advantage as a key lever to address health inequity. The 2023 Proposed Rule and Rate Notice includes several proposals that incentivize social needs screening and intervention.
In addition to Special Needs Plans (SNPs) adding standardized screening questions on SDoH, CMS also proposed a new Star Rating measure to address whether health-related social needs (HRSNs) are assessed. CMS also launched the Accountable Health Communities Model in 2016. This tested whether systematically identifying and addressing social determinants of health could impact healthcare costs and reduce healthcare utilization. Findings were mixed but highlighted the importance of addressing SDoH and HRSNs.
A HEDIS measure for Social Need Screening and Intervention was also discussed with the National Committee for Quality Assurance (NCQA). The new measure called Social Need Screening and Intervention would be for Measurement Year 2023. It would measure the percentage of members who were screened, using pre-specified instruments, at least once during the measurement period for unmet food, housing, and transportation needs and received a corresponding intervention if they screened positive. This shows how seriously CMS and NCQA are taking social determinants of health.
Progress Being Made in Social Determinants of Health Brief
The key stats in Humana’s brief show progress. 32% of Humana’s Medicare Advantage (MA) beneficiaries screened for social determinants of health in 2021. This is up from 15% in 2019 and shows that the organization is making great strides.
Progress is also being made in shifting focus to the importance of SDoH. In fact, 83% of Family Physicians agree that it is essential to identify and help address social determinants of health. The issue is that only 16% of physician practices report actually screening for them.
Humana has a goal to combat that and expand the incorporation of social determinants of health into care plans. They list main priorities as:
- Maintain and invest in Humana’s SDOH and HRSN data ecosystem
- Support healthcare providers to effectively and efficiently integrate social needs care
- Promote SDOH data interoperability
To read the entire Social Determinants of Health Data Issue Brief, click here.
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