social determinants of health

While the annual Datapalooza conference continued to focus on exploring how the health care industry is leveraging data to improve the physician/consumer care experience, AcademyHealth’s National Health Policy Conference focused on the nation’s health policy agenda.

Several leaders and subject matter experts from Humana spoke at both conferences, primarily focusing on how to address social determinants of health (SDoH) in order to slow chronic disease progression. Humana has made progress in addressing the social determinants of health. In 2019, the company scaled social determinants of health screenings to over 1 million, more than double the number of screenings in 2018, and connected those in need to community resources.

Jennifer Spear kicked off Tuesday by speaking on a panel titled “Understanding How Medicare Advantage Plans Can Address Social Determinants of Health.” The panel was moderated by David Meyers, Brown University School of Public Health, and focused on research findings based on interviews with 32 Medicare Advantage plans that made decisions to offer supplemental benefits to address social determinants of health. Lucy Theilheimer, Meals on Wheels America, was also a panelist.

During the panel, Jennifer spoke about Humana’s work on social determinants of health and how it led to the Humana/Meals on Wheels partnership. “We focused early on food insecurity due to a high prevalence of Unhealthy Days,” she said. “We found that food insecure members we were screening had twice as many Unhealthy Days as their food secure counterparts…One of the reasons that we focused our early work in the physician’s office was that we knew how important it was to be able to impact the member holistically, whether it’s in the physician’s office, in their home or working with their Humana care team.”

Jennifer also said that when it comes to social determinants of health, it is essential to “understand the population, and that takes robust data collection.” She also said it is important to “have a better understanding of how this all comes together…None of this is happening in a vacuum. No one is just food insecure or transportation insecure. There are a lot of different things impacting each of these.”

Jennifer said a customized approach is important, since “every community is different. Every market that we have is so different. You don’t have the same types of members and preferences in South Florida that you do in Louisiana, and the same is true for other communities.”

The importance of a localized approach to tackling social determinants of health was also a focus of a joint panel titled “Partnerships for Effectively Addressing Social Determinants in High Risk Populations,” in which Dr. Andrew Renda participated. The panel was moderated by Nancy Delew, U.S. Department of Health and Human Services.

During the discussion, Dr. Renda spoke about how Humana analyzed the Robert Wood Johnson Foundation’s County Health Rankings SDoH data alongside the company’s use of the CDC “Healthy Days” population health measure. That early analysis led to segmentation, predictive modeling and natural language processing to gain insights into how social determinants of health were impacting Humana’s Medicare Advantage population.

While Dr. Renda stressed the importance of being able to measure quality of life, he said resources in the community were essential to success. “We have a lot of data, but you can’t design a population health strategy from an ivory tower,” he said.  “You have to have boots on the ground, and you have to engage local stakeholders to figure out what those issues are.”  He also stressed the importance of integrating SDoH into clinical care models by adding, “We need to start treating social determinants of health like clinical gaps in care. They are critical to health outcomes.”

Dr. Renda also said, “We have to start thinking about social needs and community organizations as being health related so that we can start designing a strategy that addresses both people who already have chronic conditions and those who have social needs that put them at risk for developing chronic conditions.”

In addition, Amit Parulekar participated in a discussion titled “HDP Rapid Fire: Innovative Methodologies and Approaches to Leverage Data Today,” which also featured subject matter experts from Mathematica, Booz Allen Hamilton and IMPAQ International, LLC.

“Data plays a huge rule in treating the ‘whole person,’ and social determinants of health data is becoming increasingly important,” said Amit, who also argued that “population health programs need a holistic view, by taking into account both the medical and social needs of the person.”

Amit also said, “Since social determinants play such a huge role in total health of the individual, there is a compelling reason for considering social risk factors along with clinical risk factors into future population-based payment reimbursement models.” He also spoke on how Humana’s data analytics transforms fragmented data sources into an integrated Social Health Record at the person level.

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The annual Datapalooza conference — which is sponsored by AcademyHealth and takes place in Washington, D.C. — explores how the health care industry can harness the power of data to improve the health care experience for physicians and patients.

The conference is “the gathering place for people and organizations creating knowledge from data and pioneering innovations that drive health policy and practice.” It took place alongside the AcademyHealth National Health Policy Conference (NHPC).

On Monday, the first day of the conference, Angela Hagan, Associate Director, Population Health Strategy, Bold Goal, moderated a panel titled “Implementing Social Determinants of Health Screenings: Which Ones?” Caroline Fichtenberg, University of California, San Francisco; Jessa (Engelberg) Anderson, West Health Institute, ServiceNow; and Clare Tanner, Michigan Public Health Institute, served as panelists.

For the last several years, Humana has been focused on addressing social determinants of health and health-related social needs, with a strong focus on food insecurity, social isolation and loneliness as part of its Bold Goal, a population health strategy to improve the health of the communities it serves 20 percent by 2020 and beyond.

Angela began the panel discussion with an overview of how Humana is now screening more broadly for the social determinants of health. During her opening remarks, Angela detailed how Humana recently screened over 100,000 Medicare Advantage members for a comprehensive set of social needs, which enabled Humana to enhance its SDoH data ecosystem and analyze how multiple social need domains, including financial strain, housing insecurity and quality, and transportation access are influencing clinical health outcomes, clinical quality measures and health care utilization.

“Humana has a great interest in understanding the health-related social needs and SDoH that our members face,” she said. “Everyone knows those factors outside the clinical setting, outside of the few hours you spent in a doctor’s office, are the things that are really impacting your quality of life.”

Angela also spoke to the importance of the eHealth Initiative collaboration around ICD-10, along with the SIREN-led Gravity Project, and the importance of coding for the social determinants of health. After she finished her opening remarks, each of the panelists spoke to different types of screening tools being used to screen for social determinants of health and how to implement across sectors. The panelists also discussed whether there should be standardized tools for screening for the social determinants of health, or if we should continue to leverage specialized tools for different populations.

At the end of the panel discussion, Angela concluded that providers, health plans, state and local governments and nonprofit organizations are “on a journey together” when it comes to the importance of community and industry working together to successfully address the social determinants of health, citing how Humana’s Bold Goal has been successful in driving these types of partnerships across the health ecosystem.

Angela said, “We all need to be doing more screenings for the social determinants of health, and it’s not necessarily important to have one specific screening mechanism or tool, but we need to have some common mapping to be able to share data with partners across sectors.”

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Military suicides are at an all-time high, and social determinants of health such as loneliness and social isolation are playing a role.

Three Humana leaders — Kristin Russell, Chris Hunter and William Shrank — have written a blog article for Health Affairs calling attention to the problem.

“In the US military population, there have been a staggering 45,000 suicides in the past six years, and particular groups in the military such as veterans have especially high suicide rates,” they wrote. “In fact, the suicide rate for veterans is 1.5 times the rate of non-veterans.

“Our military members deserve and require special attention. Health care initiatives that take the unique needs of this population into account are essential, and efforts to reduce military suicides must include tailored interventions to address loneliness. Health plans, providers, community organizations, and government agencies can all play a role in better understanding and combatting loneliness in the military. Targeting the social determinants of suicide is all of our responsibility.”

Read the full article here.

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Two new investments in New Orleans total $1 million and will address financial asset security, post-secondary attainment and sustaining employment, and food security

– Contributions totaling $6.6 million to 10 organizations in eight communities mark reinvestments and an expanded investment in successful programs helping people achieve greater health equity

The Humana Foundation, philanthropic arm of Humana Inc. (NYSE: HUM) for the past 38 years, is investing $7.6 million in eight communities across the southeastern United States to address social determinants of health on a local level, helping more people achieve health equity. Part of its ongoing Strategic Community Investment Program, The Humana Foundation will create two new investments in New Orleans totaling $1 million and will continue its existing investments with 10 organizations in seven other communities, including expanding its investment in Baton Rouge, La.

Through partnerships with local organizations and community members, The Humana Foundation’s Strategic Community Investment Program creates measurable results in some of the most common social determinants of health, including post-secondary attainment and sustaining employment, social connectedness, financial asset security and food security. These investments are located in Humana ‘Bold Goal’ communities, places where Humana and The Humana Foundation are working to help people improve their health 20 percent by 2020 and beyond.

“Our Strategic Community Investments holistically address social determinants of health at the systems- and community-level,” said Walter D. Woods, CEO of The Humana Foundation. “We believe this approach will positively impact health outcomes in our target communities, which our first year results confirm. Consequently, we are creating new investments in New Orleans and continuing our investments in other locations.”

Two new Strategic Community Investments in New Orleans will address financial asset security, post-secondary attainment and sustaining employment, and food security.

Kingsley House will receive an investment of $416,480 for its Career Pathways program, an employment program that helps lift families out of generational poverty by creating greater financial asset security and post-secondary attainment and sustaining employment. Kingsley House will collaborate with DePaul Community Health Centers and Crescent City Family Services to help families access community resources.

Growing Local Food Collaborative will receive $613,620 to address financial asset security, post-secondary attainment and sustaining employment, and food security in New Orleans. The program will take a unique, cooperative approach by working through local partnerships to bring fresh food into food deserts, to create new markets and train local farmers, and to provide training and an employment pipeline for youth in the local food and hospitality economy. Partners in this initiative include, Liberty’s Kitchen, New Orleans Food Policy Advisory Committee, Recirculating Farms Coalition, SPROUT NOLA, Top Box Foods Louisiana, and joined by Second Harvest Food Bank for special projects.

In the first year of the Strategic Community Investment Program, The Humana Foundation invested $7.4 million in seven communities and funded programs that served more than 16,000 individuals and their families, addressing one or more social determinant of health. Each of these seven communities will receive continued or expanded Humana Foundation investments based on the measurable results each program attained in its first year.

The Humana Foundation’s continuing and expanded Strategic Community Investments include the following:

Baton Rouge, La: Healthy BR  will receive $715,000 to continue improving food security and social connectedness via the Geaux Get Healthy project. Funded by both The Humana Foundation and Blue Cross Blue Shield of Louisiana Foundation this project addresses food deserts by saturating areas with the highest rates of food insecurity and health disparities with numerous access points for purchasing fresh food at an affordable price. HOPE Ministries will receive an additional $189,700 as a key partner in the Geaux Get Healthy project, allowing for the expansion of a workforce development program. By investing in HOPE Ministries’ The Way to Work program, The Humana Foundation is expanding its Strategic Community Investment in Baton Rouge to address post-secondary attainment and sustaining employment.

Broward County, Fla: Broward Community & Family Health Centers will receive $415,000 to continue working with health clinics to screen patients for food security and diet-related disease. Engaging Patients Impacting Care (EPIC) will also help people apply for Supplemental Nutritional Assistance Program (SNAP) benefits and help people access healthy foods via a produce prescription program.

Jacksonville, Fla: The University of Florida  will receive continued funding of $815,000 for Health-Smart, a program that promotes social connection and food security among minority, underserved and low-income seniors, as well as asset security and post-secondary success resources for their families in partnership with the Jacksonville Urban League.

Knoxville, Tenn.: InterFaith Health Clinic, in a collaborative partnership with Catapult 4D, will receive $965,000 to continue its Truck2Table program, addressing social determinants of health and improving the health and quality of life of uninsured and underserved people by providing affordable access to healthy food, free nutrition education and access to social connectedness resources.

Louisville, Ky.: The Family Scholar House  will receive an additional $515,000 investment for its HEROES program, expanding existing programs and reaching more individuals, families and senior citizens to assess and address barriers including social isolation, food insecurity and lack of post-secondary educational attainment.  Metro United Way will receive $715,000 to continue AcceLOUrate Savings financial literacy program, improving financial independence and providing families and residents experiencing economic distress with financial literacy coaching and other social services.

San Antonio: Older Adults Technology Services (OATS) will receive $915,000 to continue its Senior Planet San Antonio program, addressing social connectedness by engaging seniors through free access to internet-connected technology and training courses. The San Antonio Food Bank  will receive $708,462 to continue its Healthy Options for the Elderly (HOPE) program, assisting seniors who screen positive for food security and social connectedness concerns with comprehensive services that stabilize their household and address prevalent health issues.

Tampa: Feeding Tampa Bay will receive $640,500 to continue work to transform affordable access to healthy food in partnership with local clinics and other social service providers via the Feeding Tampa Bay Food Pharmacy. Community Health Centers of Pinellas (CHCP) will be a key partner in this work, creating an onsite food pharmacy at the CHCP clinic and increasing access to healthy foods for the neighborhood surround the clinic.

For more information on specific investment results, please visit the Strategic Community Investment section of

Each organization that receives a Humana Foundation Strategic Community Investment has the opportunity to receive continued funding for up to three years based on the specific results achieved in their programs.

“Health is local, driven by choices available to people in their communities and neighborhoods,” Woods added. “We are grateful to work with local organizations to improve and sustain positive health outcomes.”

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With a mission to address significant health disparities and unsustainably high health care costs in the United States, the University of Houston has hired an accomplished physician and leader in medical education and health services research to direct the Humana Integrated Health System Sciences Institute. Dr. LeChauncy Woodard becomes the first director of the Humana Institute, which is committed to producing high-impact research that changes policy, innovative educational programs that prepare a new generation of health care providers and novel programs that support community transformation.

Woodard is a general internist and joins the UH College of Medicine after two decades at Baylor College of Medicine where she held several faculty positions in the departments of internal medicine, family and community medicine and more. She was also the director of the Center of Excellence in Primary Care Education at the Michael E. DeBakey VA Medical Center.

“It’s a really exciting opportunity because the unique partnership with Humana provides the foundation to unite the existing health disciplines at UH with the new College of Medicine which will enable our students to collaborate and lead integrated health care teams to increase the value and quality of care for patients,” said Woodard, whose vast research portfolio includes a focus on quality of care, treatment and prevention of chronic diseases, health disparities, and the interrelated social, economic and environmental factors that contribute to health outcomes.

Woodard said she plans to harness UH’s research expertise and form cross-disciplinary teams to tackle the most pressing complex health care problems. “I’m particularly excited to work with the underserved communities of Houston because I grew up in one. I believe that if we take care of the sickest people then we can elevate the health of the entire population.”

Woodard grew up in the Acres Homes neighborhood of northwest Houston where poverty is high and access to health care is low. Her late father’s struggle with chronic illness fueled her passion for medicine and desire to improve health disparities.

“It really impacts the quality of life for the whole family and limits the things you’re able to do,” she said. “I look forward to contributing in a meaningful way to address this problem.”

“We are thrilled to have Dr. Woodard join the UH family to lead the Humana Institute,” said Tray Cockerell, Strategic Relationships, Office of the Chief Medical Officer at Humana. “Dr. Woodard’s background, experience and passion for improving the health of individuals and communities aligns perfectly with our mission. She also understands the importance of integrating the components of care delivery – medicine, nursing, pharmacy, social work and other non-traditional components of the healthcare system – to achieve value in healthcare.  She will be an excellent director of the Humana Institute.”

Along with serving on the College of Medicine faculty in the Department of Health Systems and Population Health Sciences and the Department of Clinical Sciences, she will treat patients at Lone Star Circle of Care, the Federally Qualified Health Center in UH’s Health 2 building.

“Dr. Woodard is a compassionate and confident physician, educator and researcher with an impressive track record and even brighter future. She’s the perfect fit to lead the Humana Institute and our charge to transform the health care system,” said Dr. Stephen Spann, founding dean of the College of Medicine. “Her professional and personal experiences with health disparities and quality of care will ignite development of new health care models to make the system more effective, equitable and patient-centered.”

The Humana Integrated Health System Sciences Institute was launched in September 2018 with a $15 million gift from Humana Inc. (NYSE: HUM) to help defray start-up and operational costs for the College of Medicine, as well as fund endowed chairs at the colleges of nursing, pharmacy, social work, optometry and medicine. The College of Medicine is scheduled to admit thirty students in its inaugural class pending accreditation by the Liaison Committee on Medical Education.

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