Pilot Aims to Better Connect Medical Care and Social Care to Improve Community Health
PITTSBURGH (June 2, 2022) — Highmark Health and Allegheny Health Network (AHN) today announced the launch of a multi-year initiative to create a high-performing social care network that will compensate non-profits that address social determinants of health, such as food insecurity, transportation barriers, and housing, for patients referred by the healthcare system. In the first year of the pilot, 20 non-profits that serve Allegheny and Westmoreland Counties will participate in the program and have the potential to earn value-based reimbursement.
"Providers and the health system regularly rely on community organizations to help provide social care because caring for the whole person is central to improving health outcomes, reducing health disparities, and ultimately freeing people to be their best," said Nebeyou Abebe, senior vice president of social determinants of health with Highmark Health.
Social determinants of health are the conditions in which people live, work, learn, and play that can impact up to 80% of an individual’s health outcomes before the health care system can intervene, according to the US Department of Health and Human Services. Studies indicate that connecting individuals to social care can reduce health expenditures by thousands of dollars per year, creating significant value for individuals, employers, and taxpayers.
"This initiative will help us to collectively test and learn how to build an effective and resilient social care network, and then scale the model to other communities," said Tony Farah, MD, EVP and chief medical and clinical transformation officer at Highmark Health. "We will also be able to create the much-needed link between those patients whose social needs are addressed and the healthcare delivery system so that their health outcomes are improved and the burden of the otherwise avoidable healthcare costs is reduced."
In May of 2021, the Richard King Mellon Foundation awarded Highmark Health a $5 million grant to help develop digital health solutions that will use curated data based, personalized, clinician prescribed and fully integrated solutions for promoting a person’s whole health physical, mental and social. A portion of that grant supported Highmark Health’s effort to design the program, engage community benefit organizations, and build the data infrastructure to measure the program’s impact. Next year, Highmark Health plans to add 20 additional non-profits to the program.
"Through the Foundation’s Health & Well-Being program, we seek to ensure that everyone in Allegheny and Westmoreland counties, particularly the most vulnerable, have the opportunity to live a healthy life," said Foundation Director Sam Reiman. "One of the keys to creating those opportunities is to harness the power of data empowering medical professionals and social-service providers to have greater positive impact on their patients and clients, and individuals to have greater control over their own health. Our Board approved this significant funding because we believe this partnership can advance that important work significantly."
Individuals facing social needs can visit ahn.findhelp.com/ to find free or reduced-cost services in their community. The site connects individuals to thousands of local organizations and programs to access food, housing, transportation, utility assistance, medical care, job training and more.
List of Community Based Organizations Participating in Year 1 of the Pilot.
Highmark Health, a Pittsburgh, PA-based enterprise that employs more than 37,000 people who serve millions of Americans across the country, is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to approximately 6.8 million members in Pennsylvania, West Virginia, Delaware and New York as well as dental insurance, and related health products through a national network of diversified businesses5. Allegheny Health Network is an integrated delivery network comprised of 14 hospitals, more than 2,000 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions is focused on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge, and integrated cloud-based platforms. Lumevity, a wholly owned subsidiary of Highmark Health, helps companies transform in ways that drive direct financial benefits while improving quality and increasing employee engagement. To learn more, visit www.highmarkhealth.org.