Safety net plans use public records, claims data to glean social determinant information: survey

Dollar bill with a hole in Washington's face on it and the word "Medicaid" in its place
A recent survey of safety net plans found a large majority are using social determinants to classify risk for patients. (zimmytws/GettyImages)

Safety net health plans mainly rely on claims and diagnostic codes as well as public records and member engagement to glean data on social determinants of health (SDOH), a new survey found.

The Association for Community Affiliated Plans and the care management technology company Altruista Health recently surveyed leaders of safety net health plans that include Medicaid managed care and dual-eligible beneficiaries. The survey listed SDOH as one of the top priorities in care management.

“The emphasis in healthcare on SDOH is on every safety net health plan’s agenda,” the survey said.

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The top way plans get social determinants data is via claims and codes with 44% of responses. The second most popular method was a tie between public records and member engagement, both with 38%. But 19% said that they need more access to data.

ACAP added that 84% of plans surveyed intend to use SDOH as a factor when determining whether a beneficiary is a high or low health risk. Another 67% say they are working with community partners to address SDOH.

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The top social determinants affecting safety-net plans were housing (18%), poverty (14%) and food insecurity (13%) and employment (13%). But two plans surveyed added that loneliness was a major SDOH.

“Loneliness acts as a fertilizer for other diseases,” said Steve Cole, director of the Social Genomics Core Laboratory at the University of California, in a release on the survey.

Insurers are starting to make moves to add loneliness to SDOH priorities. Medicare Advantage insurers such as Humana are working to identify loneliness in their patient populations and find methods to combat it.

The survey went out to the 70 plans that make up ACAP’s membership and 22% responded.

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