Health Insurers’ Push Into Social Determinants of Health: A Move Toward Equity or Financial Strategy?
In recent years, health insurers have begun investing heavily in programs targeting social determinants of health (SDOH) in an effort to improve public health and reduce chronic illness. The Biden Administration’s U.S. Playbook to Address Social Determinants of Health highlights the need to address factors like education, housing, and transportation, which are closely linked to health outcomes. However, there is debate over whether these insurer-led efforts are truly aimed at improving health equity or driven by financial incentives.
Insurers such as UnitedHealth Group and Humana have spent billions on SDOH initiatives. A study from Harvard and Oxford revealed that private insurers invested at least $1.87 billion between 2017 and 2021. While these investments have led to meaningful collaborations with community organizations, Whitney Perkins Witt, CEO of The Health Equity Consulting Group, says there’s still much room for growth. For example, UnitedHealthcare's effort in Baltimore, which increased mammogram participation by offering mobile mammography and childcare, is a notable success in reducing barriers to care. Data, however, remains a challenge. Insurers often use risk-screening tools to assess members’ needs, but the lack of consistent and standardized data makes it difficult to measure the long-term impact of these initiatives. Kaiser Permanente, for instance, has begun using AI-powered tools to better track patient outcomes, particularly in improving medication adherence. Critics argue that these initiatives may serve other purposes. Chris Pope from the Manhattan Institute claims that insurers are using SDOH programs to secure additional Medicaid and Medicare funding, rather than genuinely improving health outcomes. He suggests that investments in areas like housing may not reduce healthcare costs and could instead be a way for insurers to gain more government funding. Despite skepticism, advocates believe that addressing SDOH can prevent costly healthcare crises and save the system billions in the long term. Though the financial returns may take time to materialize, proponents argue that insurers are well-equipped to drive large-scale, positive change through their financial resources and technological advancements.
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