Healthworx, the investment and innovation arm of CareFirst BlueCross BlueShield (CareFirst), recently expanded their relationship with existing portfolio company, Socially Determined, to address one of the toughest challenges in the industry: integrating social determinates of health into meaningful, measurable programs to improve member health outcomes.
COVID-19 spurred important conversations about health equity, and in turn, data. Population health work is not possible without access to data that accurately represents all populations and their experiences.
By utilizing the Socially Determined SocialScape platform, CareFirst can identify members who face elevated health risks across social risk domains such as financial strain, food insecurity, housing instability, transportation barriers and health literacy challenges. Once CareFirst identifies these baseline disparities within its 3.5 million members, social risks can be used to identify underlying inequities that are driving disparities and tailor the BlueCross BlueShield Association’s (BCBSA) National Health Equity Strategy based on that data.
“That is our wider goal,” Djinge Lindsay, MD, MPH, Director of Public Health at CareFirst, said in a recent article. “If we understand where there are disparities, then there has to be something driving those inequities. That is where this understanding of social risk, and the social constructs that are influencing our members is going to become very helpful.”
CareFirst initially engaged Socially Determined in January 2021 with an investment of more than $10.5 million to provide support for the State of Maryland’s Diabetes Action Plan and improve health outcomes for people in the mid-Atlantic region who have a diagnosis of or are at a higher risk of developing diabetes.
CareFirst worked with Socially Determined to analyze data in six pilot communities, including a range of social risk factors like economic climate, food insecurity, health literacy and other factors that influence the health of people and their communities. Their data discovered members with these social risks faced a significant increase in total cost of care compared to other members. CareFirst was then able to allocate resources accordingly, distributing $1.76 million in grant funding to 27 local health organizations working to combat diabetes across the Baltimore/DC region.
“Looking at the community and member data Socially Determined provided that looked at cost of care, we were able to say we should be directing those diabetes investment dollars to communities that have high risk for health illiteracy and high risk for food insecurity. Our entire grant strategy was built off the data Socially Determined provided,” Lindsay said. “We understand that it’s not just care for our members that we need to be impacting. We also want to have a focus on our larger community.”
Socially Determined recently completed a successful Series B funding round to secure $26 million and expand their platform and service options. Within this partnership, CareFirst will benefit from these enhancements, accessing data around social risks in combination with clinical risks to better identify members who are at risk for poor outcomes and elevate care management strategies in response.
Members and communities benefit from strategies that move healthcare past where it has been. Healthworx and CareFirst are thinking about things differently and addressing problems communities face differently thanks to collaborative work like this.