The Blue Cross Blue Shield Association (BCBSA), the parent company for 36 Blues companies spread across the country, has launched the Blue Cross Blue Shield Institute to address social determinants of health (SDOH) and the influence on health and outcomes.
The initiative includes partnerships with Lyft, CVS Health and Walgreens that will address “transportation and pharmacy deserts” in test markets.
The institute will combine “a social mission with business innovation and insight to target barriers to healthcare that can be solved with technology and strategic alliances."
Scott Serota, CEO of BCBSA and chairman of the board of the BCBS Institute, noted that health is often more connected to an individual's ZIP code rather than their genetic code.
With that in mind, the organization will look at potential issues involving transportation, pharmacy, nutrition and fitness in communities. Similar to other SDOH initiatives, BCBS Institute will target help to at-risk members beyond the physician’s offices and hospitals.
"For some of our members, it can be difficult to get to a physician's office for treatment, to the pharmacy for much-needed medication, to the grocery store for nutritious food or to a safe place to exercise," Serota said. "We want to help lift these burdens for more Americans."
Dr. Trent Haywood, BCBSA chief medical officer and president of the BCBS Institute, said 60% of health outcomes “are driven by social determinants of health, including lifestyle behaviors and environmental factors.”
The BCBS Institute will tackle nutrition and fitness deserts in 2019.
Providers and payers have increasingly used social data to tackle population health efforts. They see how a lack of transportation, housing and access to food can impede healthy lifestyles and regular healthcare visits.
SDOH efforts involve payers, providers and community groups. Payers use analytics to coordinate care and offer value-based payments, providers care for the patients and community programs assist patients outside of the healthcare setting. Some experts believe accountable care organizations will help foster these kinds of collaborations.
Other major payers are embracing SDOH initiatives.
Aetna CEO Mark Bertolini speaks frequently on the topic. At the Washington Ideas Forum in September, he said providers and payers should take a more personalized approach with their patients. "You have to go back to local," he said. "You have to be in communities and in the neighborhoods and talk about what works."
Though healthcare organizations understand the issues with SDOH, questions remain about whether population health programs can save money.
There are some encouraging signs.
For instance, Health Affairs highlighted a Colorado program called Bridges to Care, which brought together emergency departments, physicians, behavioral health professionals and community programs to promote primary care. The program offers care coordinators, health coaches, behavioral health specialists and community health workers.
The study found after six months a 28% reduction in ED visits and 114% more primary care visits compared to patients in the control group. These numbers were even better for patients with mental health comorbidities — 30% fewer ED visits, 30% fewer hospitalizations and 123% more primary care visits compared to the control group.