New capability helps identify people in employer-sponsored benefit plans who are most likely in need of support, proactively connecting them to low- or no-cost community resources
Program builds on existing initiatives for UnitedHealthcare Medicare and Medicaid beneficiaries, along with previous work with the American Medical Association to more precisely diagnose social determinants of health
UnitedHealthcare has introduced the use of predictive analytics to help improve well-being, lower costs and drive engagement in clinical-intervention programs by addressing social determinants of health for people in some employer-sponsored benefit plans.1
Building on similar initiatives for UnitedHealthcare Medicare and Medicaid beneficiaries, the new capability adds the use of predictive analytics to help efficiently identify people in need of support related to social determinants of health. The resource is currently available to employers that select UnitedHealthcare’s Advocate4Me Elite or Advocate4Me Premier product offerings, with plans to introduce a customized version for employers with fully insured health benefits later this year.
The new advocacy capability uses de-identified claims data from UnitedHealthcare members to proactively identify who is most likely to need support with social determinants of health, such as access to nutritious food or affordable housing. UnitedHealthcare call center advocates then use real-time interactions coupled with a curated database of community resources to help individuals dealing with challenging life events or circumstances.
UnitedHealthcare, and its parent company, UnitedHealth Group (NYSE: UNH), has long invested in helping address social determinants of health, including providing more than 1 million referrals to important social services and contributing over $500 million to support affordable housing for people across the country. In addition, UnitedHealthcare previously collaborated with the American Medical Association to develop ICD-10 codes to more precisely diagnose social determinants of health.
“UnitedHealthcare is in a unique position to help improve people’s health and well-being by addressing social determinants of health,” said Rebecca Madsen, chief consumer officer, UnitedHealthcare. “With COVID-19 highlighting the need to help close the gap between health care and access to services that contribute to well-being, UnitedHealthcare has incorporated social determinants of health into our advocacy service model, providing people with important support as they navigate the health system.”
Research suggests that various social barriers impact up to 80% of a person’s health.2
Developed in collaboration with Optum, the UnitedHealthcare capability can help employers predict the likelihood that their employees may have a need for a social intervention, assessing more than 300 markets across the country and analyzing over 100 metrics. By combining this information with the employer’s aggregate claims data, employers can design and implement health care strategies that are more responsive to challenges their employees may face and proactively identify the need for support.
The targeted support model is intended to engage and assist people by helping reduce or eliminate barriers to well-being, diminish out-of-pocket consumer costs and avoid potential expenses for employers. UnitedHealthcare call center staff are trained to listen for key words, such as “I’m hungry,” “I’m having trouble making ends meet,” or “I’m stressed,” and then proactively connect the individual to low- or no-cost community resources. Through the capability, UnitedHealthcare helps people:
The recommended resources have been evaluated and vetted as providing quality, cost-effective services. Since introducing the capability, eligible individuals have accepted over 50% of the offers for support.3
UnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.3 million physicians and care professionals, and 6,500 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified health care company. For more information, visit UnitedHealthcare at www.uhc.com or follow @UHC on Twitter.
1 UnitedHealthcare employer study (2019) of 112 clients with 4.3 million members. Medical costs adjusted for age, gender, risk, geography, cost outliers and other design features for comparability. Value impact based on comparing clients by the adoption platform features vs. not (e.g., highly designated service vs. base service model). Actual client results may vary based on specific clinical programs the client has or maturity of implementation.
2 Robert Wood Johnson Foundation, 2019, https://www.rwjf.org/en/library/research/2019/02/medicaid-s-role-in-addressing-social-determinants-of-health.html
3 UnitedHealthcare internal analysis of participating employers, 2021