UnitedHealth, HAC study: How social health factors impact employer plans

Given the impact that social factors have on overall health, employers can better manage costs and outcomes by embracing deeper, population-level data analysis, according to a new white paper.

UnitedHealthcare and the Health Action Council (HAC), a nonprofit that represents large and midsize employers, dug into community health data from HAC's plan sponsors representing 217,779 workers. The analysis found that 52% of adults have at least one social determinant of health risk.

Of that group, 10% faced three or more risks, and 16% had two risk factors. Twenty-six percent have one SDOH risk factor, according to the report.

Craig Kurtzweil, chief data and analytics officer for UnitedHealthcare Employer and Individual, told Fierce Healthcare that the study "gives us a first of its kind sort of view of all the different variables that are impacting the health of various communities and employers."

"As you dive a little bit further, it just becomes a bit remarkable how much of an impact those factors are making," he said.

The report focuses on several regions of the U.S. It found, for example, a far higher rate of premature mortality, or deaths before age 75, in South Carolina than in California. There were 10,898 premature deaths per 100,000 in South Carolina, and 7,020 per 100,000 across the country in California.

The national average, for comparison, was 8,659 premature deaths per 100,000, according to the report.

People living in states with lower health scores and greater risk had elevated health costs compared to those facing fewer risk factors, according to the report. Among the HAC population specifically, 66% lived in the 20 lowest-ranked states based on several health factors.

If that group lived in the top 20 states for outcomes, however, per member per month health costs could be reduced by $61 million each year, according to the study, or about 7% of trend.

In addition to comparing risks and outcomes across different regions, the study also looks at how SDOH are effecting different age groups. It found that younger HAC employees tend to have greater risk for social health challenges compared to older workers.

Millennials, which represented the second-largest cohort in study at 35% of workers, had the highest likelihood of three or more SDOH risk factors, which was identified in 13% of this population. Generation Z was close behind, with 11% seeing at least three social risk factors.

The highest risks for both groups were financial challenges and social isolation. Nearly half (45%) of the millennial workers faced financial health issues, as did 30% of Gen Z workers.

Thirty-eight percent of millennials said they were socially isolated, as did 36% of Gen Zers. Among the older age groups, 36% of Gen X workers reported financial health issues, but far lower rates of other challenges.

Kurtzweil said that millennials as a cohort are reaching ages where they are facing greater health risks than ever before, and they also want to seek care in more convenient and virtual spaces rather than traditional brick-and-mortar locations.

"As you think about the U.S. healthcare system, basically it was created to support baby boomers," he said. "And now millennials use and access to the healthcare system just just incredibly different ways than baby boomers, and the whole healthcare system is going to need to adjust and adjust quickly. "

The report concludes with some action items that employers can take to do a better job in managing population-level health outcomes. For one, it's critical for these firms to expand their data set to include information on SDOH, community-level information and geographic regions.

Patty Starr, president and CEO of HAC, told Fierce Healthcare that drilling down to subpopulations makes it easier to offer direct education and support that can meet that group's or that individual's needs.

"Traditionally, as employers, I believe that we've looked at our data more globally," she said. "If I'm trying to support my employees, where they may need to take action in one region may not be the same action they need to take in another area."

"For an employer to actually drive change, now they can drill down into sub populations to really understand what's impacting each of those populations within a given region or given area," Starr said.