Blue KC and Healthify discuss how innovations in SDoH will evolve in the wake of COVID-19.
After weeks of shelter-in-place mandates, states are beginning to open back up. However, the impacts stemming from the COVID-19 pandemic are here to stay for the foreseeable future. Local food pantries and social services are already noticing an increase in service demands. As the unemployment rate rises, we can only expect an increased demand for social support networks. With many CBOs already strapped for funding and facing limited capacity, addressing social determinants of health (SDoH) will be a continued challenge.
“The pandemic is placing a large strain on community organizations and is shining a light on the infrastructure challenges for the social services sector across the country,” Manik Bhat, Healthify’s founder and Chief Strategy Officer, said on a recent Healthify-hosted webinar.
Bhat was joined by Jerry Jones, Director of Community Health at Blue Cross and Blue Shield of Kansas City (Blue KC), to discuss how innovations in SDoH will evolve in the wake of COVID-19. Both are hopeful that future policies will build payment structures to sustainably address capacity concerns.
How COVID-19 re-shaped the SDoH landscape
When shelter-in-place measures began, it fundamentally changed the U.S. economy. Many businesses closed, causing unemployment claims to rise to record levels. As a result, communities are experiencing an increased need for food, childcare services, and other social supports. The increases in demand have put a spotlight on the operational vulnerabilities of many CBOs.
CBOs — many troubled by low funding — have reduced service hours, their workforce, or closed permanently. For example, Bhat shared data that found 20% of food-related CBOs closed in major cities, and about 70% are changing their services or hours.
As the shelter-in-place orders are lifted, the need for social services will persist — in particular, food and housing services — and the capacity for CBOs to meet these needs will continue to be strained. Therefore, new, sustainable delivery models must emerge for social services as America recovers from COVID-19.
Health plans are using data to drive new SDoH intervention strategies
Social and health inequalities existed before COVID-19 — but the pandemic illuminated how dire the social safety net is for vulnerable populations. “COVID-19 is the ultimate pressure test for SDoH,” Jones said.
Before COVID-19 hit Kansas City, health inequalities were already clear. Those who graduated high school were less likely to have diabetes. Residents making up to $25,000 were more likely to have diabetes than those making over $75,000. In the wake of COVID-19, capacity demands immediately challenged Kansas City CBOs. One survey found that area CBOs reported an increased need for economic, food, and health services.
To address capacity challenges, Blue KC brainstormed how to use their findings to develop an action plan that leveraged its newly launched Healthify network.
Using the power of Healthify’s Kansas City network, Blue KC ran an internal analysis on members to identify admissions, testing rates, discharges, and those who are at risk related to COVID-19 then overlaid that data with community-level data.
Based on the findings of that analysis, Blue KC quickly started a program to identify and support members diagnosed with COVID-19 to shelter-in-place safely. Once identified, Blue KC sends care packages of basic supplies such as hand sanitizer, soap, and thermometers. It’s a simple intervention, but Jones said it’s helping members recover comfortably and taking pressure off of CBOs.
Another program that Blue KC is exploring with Healthify is providing contactless food delivery services to food insecure members who test positive for COVID-19.
“The essential piece is understanding what the data are telling you,” Jones said. “Once you have those, then you’re able to move forward with action steps.”
The future of SDoH innovation in a post-COVID-19 era
“We’re in a moment in time where everyone has eyes on unmet social needs and impact,” Bhat said. There’s no doubt that both the healthcare and social services sectors will change, but it’s hard to imagine precisely how.
Bhat believes that the data currently being produced has substantial policy implications. “The data that’s currently being generated around need and access is going to help drive initiatives forward to support not only the model of accountable networks with health plans and community partners but also with providers,” Bhat said.
“The dream,” he says, "is to ultimately create value-based community care." This future-state would create accountability standards — structured around ROI and credentialing frameworks — for SDoH to drive payments to community partners.
This isn’t out-of-the-box thinking. We already expected innovations in payment systems to emerge. But with COVID-19 as a forcing function, not only would payment reform create another revenue stream for CBOs, but also create an infrastructure to support increased social service capacity demands.
“Providers have clear incentives for SDoH screening and workflows,” Bhat said. “Tying interventions and the referral process to existing value-based payment structures is exciting and the next scalable step.”
Watch the whole webinar and join the conversation on how SDoH will evolve post-COVID-19.