Highmark Social Care
Network Supports Members Beyond Medical Needs

Non-medical factors drive most health outcomes. A person's environment influences up to 80% of their overall health. External pressures can make it difficult to maintain good health — even with insurance coverage.

Highmark recognizes the impact of non-clinical factors on whole-person health. These factors are known as social determinants of health (SDOH). Our expanding Social Care Network is dedicated to meeting SDOH needs for improved quality of life, delivering on enhanced health outcomes and affordability.

What are SDOH?

Social determinants of health (SDOH) are the conditions in which people live, work, and navigate their world. SDOH include:

• Access to medical care.
• Local education and job opportunities.
• Financial solvency.
• Food insecurity, living in a food desert.
• Loneliness, isolation, lack of social ties.
• Reliable transportation.
• Stable housing in a safe community.

Individuals and families struggle when they cannot meet essential daily needs. In the workplace, SDOH can manifest as absenteeism or lack of productivity. Employees may be unable to prioritize their own wellness due to more pressing daily concerns. 

SDOH barriers can make it difficult to see the doctor, fill prescriptions, or follow a health program or treatment plan. Even the most comprehensive health coverage cannot offset challenges that prevent employees from engaging with care.

When companies understand and address these barriers, they can improve health outcomes for their people. Solving for SDOH can also show up as cost savings in the bottom line.

SDOH screening tool foremployees

Assessing employees for SDOH gaps is an important part of any whole-person health strategy. Employees complete a self-reported screening that identifies the specific challenges they face. Screening results highlight any external factors affecting health, productivity, and engagement with benefits.

Highmark offers a 15-question SDOH assessment that screens for member needs in several different categories. Questions pertain to financial strain, food insecurity, housing stability, social connections, neighborhood safety, transportation, and other SDOH.

The system adds responses to the member's profile and electronic health record, highlighting non-medical factors that affect quality of life. Working with the person, we use SDOH insights responsibly to connect individuals with targeted support and community resources through the Highmark Social Care Network.

Highmark Social Care Network

Our Social Care Network is a group of community-based organizations (CBOs) that address and report on specific SDOH barriers. These partnerships reduce barriers to health and wellness, which subsequently helps members feel better and more productive. 

Nebeyou Abebe, SVP of SDOH for Highmark Health, shares an example of how the Social Care Network makes a difference. "Take a member with diabetes who is also facing food insecurity," he says. "It's going to be next to impossible for them to adhere to their medication and control their diabetes while they’re food insecure." 

Highmark would connect the member to a CBO to help resolve their food insecurity issue. After that, we can move forward with recommendations for healthy next steps. In the scenario presented by Abebe, we would encourage the member to enroll in our diabetes management program.

We have more than 30 CBOs in our Social Care Network across parts of Pennsylvania and West Virginia. The program has been proven to lower health care costs, reduce hospital admissions, and improve overall outcomes. 

CBOs have assisted more than 1,000 individuals to date. Community partners fulfill most requests for help within weeks. The most frequent needs in the communities we serve include:

1. Financial referrals.
2. Housing support.
3. Food and nutrition.
4. Transportation.

Effectiveness of the program, as highlighted in Health Affairs Scholars¹, continues to drive growth and opportunity. The Social Care Network makes a meaningful, long term difference in health and well being, with the lasting impact of positive changes.

Highmark also recently created the Social Health Center of Excellence, led by Abebe. The Center will engage teams from throughout our business, as well as leaders from Allegheny Health Network (AHN). We seek to improve the health of our members by integrating social health throughout our business and collaborating with other dedicated organizations.

Find SDOH solutions for your employees

Employers can strengthen whole-person health by incorporating SDOH insights into their benefits strategies. Highmark can help remove barriers that prevent members from accessing care — supporting healthier, more productive employees.

Learn how SDOH solutions can reduce preventable health issues and improve overall well-being. Contact your Highmark account manager or employee health insurance broker.

_{All references to "Highmark" in this communication are references to Highmark Inc., an independent licensee of the Blue Cross Blue Shield Association, and/or to one or more of its affiliated Blue companies.}