UnitedHealthcare, AMA partner to launch new diagnostic coding for social determinants of health 

UnitedHealthcare is teaming up with the American Medical Association to grow its work using diagnostic codes for the social determinants of health. 

The two organizations will work together to launch about two dozen new ICD-10 codes that will be used to refer patients to social and government supports that can meet their non-clinical needs, UHC and AMA announced Tuesday. 

The codes will use a mix of traditional clinical data and patients’ self-reported information, according to the announcement. 

“UnitedHealthcare and the AMA share a common goal of expanding the healthcare system’s perspective to consider the whole person—not just medical care—by placing as much emphasis on people’s social needs as their clinical needs,” Bill Hagan, president of clinical services at UHC, said in the announcement. 

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UnitedHealthcare has already launched such codes in its Medicare Advantage plans, and it wants to see them expand nationwide. It also partners with the National Committee for Quality Assurance and the National Association of Community Health Centers on this work. 

In its MA plans so far, UHC has made more than 700,000 referrals to social services, equating to more than $250 million in social value. Alongside the codes, UHC is surveying its Medicare Advantage members to identify social concerns that should be tackled on a larger scale. 

For example, it launched a partnership with food delivery service Mom’s Meals, delivering 2.5 million meals to MA members last year and with plans to deliver at least 1 million additional meals in the future. 

Building this work into coding allows the insurer to better track patients and their needs, while avoiding additional administrative work for physicians, according to UnitedHealthcare. 

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The AMA is joining the project through its Integrated Health Model Initiative, an arm of the organization that’s focused on how data-sharing and innovation can boost patient outcomes. It works toward market-based solutions that meet these goals. 

Tom Giannulli, M.D., chief medical officer at IHMI, said in the announcement that one of the initiative’s efforts is to find ways to more effectively capture and monitor the social determinants of health, making the partnership with UnitedHealthcare a no-brainer. 

“The collaboration reinforces the importance of social and environmental factors in patient care, and will shape IHMI’s efforts to support clinical decisions with useful and valid data to achieve broad improvements in health and greater health equity,” Giannulli said.