AMA, UnitedHealthcare partner on SDoH initiative

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One of the nation’s largest insurers is partnering with the American Medical Association to better incorporate social determinants of health data in care delivery.

The project pairs the nation’s largest physician organization with Minnetonka, Minn.-based UnitedHealthcare, part of UnitedHealth Group. The partners plan to work together to better identify and address social determinants of health (SDoH) issues that prevent better access to care and hinder patient outcomes.

The collaboration builds on both organizations’ efforts to help underserved individuals and families get on a path to better health, executives say.

The project will build on work initiated by UnitedHealthcare to standardize how data is collected, processed and integrated regarding critical social and environmental factors that contribute to patient well-being. SDoH factors that play into patients’ health status include nonmedical issues such as food, housing, transportation, and the financial component that enables payment for medications, utilities and other services.

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While the impact of SDoH is gaining recognition, the healthcare system does not have a consistent, organized way to capture those needs and incorporate the data into a person’s overall care plan. To counter this, UnitedHealthcare and the AMA are supporting the creation of nearly two dozen new ICD-10 codes related to SDoH. By combining traditional medical data with self-reported SDoH data, the codes trigger referrals to social and government services to address people’s unique needs, connecting them directly to local and national resources in their communities.

Physicians and care providers use ICD-10 codes to classify and record all diagnoses, symptoms, and medical treatments and procedures. UnitedHealthcare has developed a data model focused on standardizing the capture and processing of SDoH-related information. Using its data model, UnitedHealthcare has made more than 700,000 social-service referrals for people enrolled in its Medicare Advantage plans since 2017.

“By working together to leverage data, technology and the incredible expertise of our network physicians, we can more effectively address the social factors that limit access to healthcare,” contends Bill Hagan, president of clinical services for UnitedHealthcare.

“The partnership builds on the AMA’s efforts through its Integrated Health Model Initiative (IHMI) to foster collaboration around innovative data and technology-driven processes for incorporating social determinants of health into routine medical care,” adds Tom Giannulli, chief medical information officer of AMA’s IHMI. “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.”

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