AHIP Highlights Health Plan Equity Efforts

These actions include substance abuse and community health center initiatives from BCBS plans and CVS Health's housing and workforce investments.

As health equity and social determinants of health (SDOH) become a growing anchor for health plan strategy, AHIP has released new updates on the actions its payer members are taking.

These actions include substance abuse and community health center initiatives from Blue Cross Blue Shield plans and CVS Health's housing and workforce investments.

These and other updates are a part of AHIP's Project Link, which includes insurer actions related not only to SDOH but also COVID-19 throughout the pandemic. AHIP notes that payers "are committed to building solutions to address the social barriers to health that can harm a patient’s overall health."

SDOH definitions, domains, and metrics vary widely but HHS and World Health Organization (WHO) definitions share the common thread that social determinants represent the conditions under which people are born, live, work, and age. While the WHO definition focuses primarily on SDOH as a cause of health inequity, HHS notes that social determinants "affect a wide range of health, functioning, and quality-of-life outcomes and risks," including:

• Economic stability
   
• Education access and quality
   
• Healthcare access and quality
   
• Neighborhood and built environment
   
• Social and community context

HealthLeaders notes these differences and how risks are categorized—e.g., the HHS includes food and housing insecurity under economic stability—to highlight that healthcare stakeholders may grapple with how to create a common, accepted language around SDOH, within their organizations and across partners. A lack of shared understanding may impact not only initiative design but may differ entirely from what people in communities in need believe their most pressing challenges are.

The following from AHIP summarizes how a variety of payers are addressing these challenges:

• AmeriHealthCaritas: This government programs-focused plan, located in 12 states and Washington, D.C., is making SDOH investment via the venture capital (VC) world. Its new subsidiary Social Determinants of Life, Inc. is the lead investor in Wider Circle, a startup that builds tech-enabled, hyper-local health programs and peer-to-peer social networks.
   
• Blue Cross Blue Shield of Michigan: The plan is one of four community partners in the Michigan Opioid Partnership, which will use nearly $500 million in grant funding to close care gaps for people with substance use disorders (SUD) in the Upper Peninsula.
   
• CVS Health: The retailer, which has expanded to not only provider but payer (acquiring Aetna), is partnering on a $6.5 million investment to help build supportive housing in Denver for individuals who are homeless or struggling with disability.
   
• Independence Blue Cross: The regional Pennsylvania payer is targeting student loan reduction and financial well-being. The plan is one of the first to partner with GradFin for these services, which are free not only to Independence members but anyone in the member's household, regardless of enrollment status.
   
• L.A. Care Health Plan and Blue Shield of California: These two payers are enhancing services as their jointly operated Community Resource Centers, which offer a variety of health and education services as well as food pantries and school supply programs.

In addition, a number of plans are investing in an aspect of SDOH that is often less discussed: digital literacy. These plans include Blue Cross Blue Shield of New Mexico, CareSource, EmblemHealth, Humana, and SCAN Health Plan. Their investments range from helping to build internet infrastructure in rural areas to teaching community-based tech classes.

Nearly every payer SDOH initiative involves multiple and diverse community partners as insurers understand that health equity is a long-term investment that requires subject matter expertise beyond their realm.