UnitedHealthcare uses predictive analytics to address SDOH

UnitedHealthcare has introduced the use of predictive analytics to help improve well-being, lower costs and drive engagement in clinical-intervention programs by addressing social determinants of health (SDOH) for people in some employer-sponsored benefit plans.

Building on similar initiatives for UnitedHealthcare Medicare and Medicaid beneficiaries, the new capability adds the use of predictive analytics to help efficiently identify people in need of support related to social determinants of health. The resource is currently available to employers that select UnitedHealthcare’s Advocate4Me Elite or Advocate4Me Premier product offerings, with plans to introduce a customized version for employers with fully insured health benefits later this year.

The new advocacy capability uses de-identified claims data from UnitedHealthcare members to proactively identify who is most likely to need support with social determinants of health, such as access to nutritious food or affordable housing. UnitedHealthcare call center advocates then use real-time interactions coupled with a curated database of community resources to help individuals dealing with challenging life events or circumstances.

UnitedHealthcare, and its parent company, UnitedHealth Group, has long invested in helping address social determinants of health, including providing more than one million referrals to important social services and contributing over $500 million to support affordable housing for people across the country. In addition, UnitedHealthcare previously collaborated with the American Medical Association to develop ICD-10 codes to diagnose social determinants of health more precisely.

Research suggests that various social barriers impact up to 80 percent of a person’s health.

Developed in collaboration with Optum, the UnitedHealthcare capability can help employers predict the likelihood that their employees may have a need for a social intervention, assessing more than 300 markets across the country and analyzing over 100 metrics. By combining this information with the employer’s aggregate claims data, employers can design and implement healthcare strategies that are more responsive to challenges their employees may face and proactively identify the need for support.

The targeted support model is intended to engage and assist people by helping reduce or eliminate barriers to well-being, diminish out-of-pocket consumer costs and avoid potential expenses for employers. UnitedHealthcare call center staff are trained to listen for key words, such as “I’m hungry,” “I’m having trouble making ends meet,” or “I’m stressed,” and then proactively connect the individual to low- or no-cost community resources. Through the capability, UnitedHealthcare helps people:

  • Find access to nutritious meals, such as through local food banks.
  • Obtain internet or smartphone access, such as through financial subsidies offered by telecommunications companies.
  • Find local support groups, including for continuing education and mentoring.
  • Obtain assistance for rent/mortgage, childcare or utility bills.

The recommended resources have been evaluated and vetted as providing quality, cost-effective services. Since introducing the capability, eligible individuals have accepted over 50 percent of the offers for support.