Meet the executive leading UnitedHealthcare's social determinants strategy

It's not a secret in the industry that social factors play a major role in people's overall health.

UnitedHealthcare's Andrew Billioux
Alex Billioux, M.D. (UnitedHealthcare)

However, the resources needed to address these social issues may be hard for most healthcare organizations to come by. At UnitedHealthcare, the scale and reach of the country's largest private insurer enable investments and initiatives that serve as a critical backbone to its relationship with members, said Alex Billioux, M.D., vice president of social determinants of health at UHC.

Billioux joined UnitedHealthcare in February 2021 after serving as the assistant secretary for health in Louisiana's Office of Public Health. In that role, he led the state's response to COVID-19 as well as other key public health priorities.

Now, he directs UnitedHealth's social determinants of health strategy across the company.

"I think one of the things that has really been eye-opening from within this company is just seeing the span of reach that a company like UnitedHealthcare has and the opportunity that it has, and frankly has been executing on for some time, to leverage our relationship with both providers and our members to be that entity to see a bigger part of the picture, if not the whole picture, and make these connections to our members," Billioux told Fierce Healthcare.

For example, the insurer has a wealth of data on its members that it's working to make available to providers. It offers a tool that embeds in the electronic health record to provide additional information on UHC members to docs at the point of care.

In the last quarter, UnitedHealthcare began feeding social determinants of health data into that tool, Billioux said. And when they're armed with that data they can make adjustments, such as changing medication regimen, as well as connect patients with services in the community to address their needs.

Most providers will acknowledge that social needs play an outsized role in health but feel ill-equipped to manage those needs, according to a recent study from Medscape.

"We think that’s critical to build those kind of aligned wins between payers and providers," Billioux said.

Providers, particularly frontline clinicians like primary care docs, are also well-positioned to identify social needs, and enabling that bidirectional data sharing allows the health plan to develop its own resources as well as flag for the provider where potential challenges may lie.

Leaning on its provider network is also a key strategy for an insurer like UnitedHealthcare to break through potential trust barriers with members, who are less likely to buy into advice offered by their health plan, he said. Public health experts agree that trust and a community connection is critical to moving the needle on social needs.

Outside of harnessing the provider relationship, however, plans like UnitedHealthcare also need to make it clear to their members that they are listening to and addressing the challenges they face, Billioux said.

"It always comes back to starting with listening and prioritizing what the member is telling us," he said. "I do think that is an important opportunity to build trust and really start to shift people's thinking, and even inside our company shift thinking, on what can be our whole-person and longitudinal role in really being that trusted adviser or trusted navigator through the healthcare system."

For example, Billioux said, when a member makes a routine call to UnitedHealthcare for a new insurance card, the call center has an opportunity to briefly screen them for common social needs, or take note of potential warning signs in the conversation about social challenges they may face.

The insurer is also investing millions in affordable housing and rolling out benefits to address transportation and food access. Digital health, and the role it can plan in addressing social health needs, is also a key area of focus, even as UnitedHealthcare weighs potential hurdles in broadband access, device access and digital literacy.

Overall, he said the insurer has connected its members with about $45 million in goods and resources for social needs, saving an average of between $1,200 and $1,500 out of pocket a year for members who have received these benefits.

Now, the focus is looking at how these programs are paying off in outcomes.

"I think that we are not just doing this for the sake of saying, 'Look, we’re reaching these high numbers,'" Billioux said. "For us, it’s really about, 'This is an intervention we have great confidence in impacting health.'"