The 5 keys to L.A. Care's new strategy for social determinants of health

The Chief Medical Officer, Medical Director, and Program Director of Health Equity at L.A. Care set out to revamp the organization’s SDoH strategy and maximize the impact of its efforts. They began this effort with a review of Advisory Board research, which helped them to:

• Develop a framework that prioritizes addressable social determinants, and that defines how to assess and address them
• Recognize that many of the resources needed by their members were already in the community

Richard, James, and Marina then prioritized five areas that they felt they could influence and that would move the dial on health outcomes: housing, food security, income security, transportation, and early childhood education And for each of these areas, the team defined which quality outcomes they should be monitoring to assess what is or is not working.

Finally, their recognition that many essential resources were already in the community led L.A. Care to double down on strengthening relationships with federal, state, and community-based organizations versus building programs from scratch.

Marina’s first priority is to ensure that the entire organization understands that social determinants are central to their mission. She conducted training sessions, developed literature, and educated everyone—from executives to customer service representatives to her colleagues working with members in L.A Care’s community resource centers—that social determinants have far more influence on health outcomes than what happens in the doctor’s office. She wants all of L.A. Care to also know which five social determinants they have prioritized, and exactly how they can connect members’ assessed needs to available resources. L.A. Care has also launched L.A. Care Community Link, a tool to help their members and the community find assistance with housing, food, bills and many other needs.

Additionally, Marina is busy searching for partners to build alliances with so that L.A. Care can continuously improve the support offered to its members. Some existing partnerships include:

• Blue Shield of California Promise Health Plan — together the two plans are building additional Community Resource Centers, and will jointly operate a total of 14 centers located throughout the county by 2024
• Project Angel Food — through this partnership, Medi-Cal patients with congestive heart failure who are at high risk for hospital readmissions are receiving free, low-sodium fresh meals
• Brilliant Corners — this agency and L.A. care are working together to provide stable housing to 300 homeless individuals

L.A. Care is working closely with the Los Angeles County Department of Public Health, and is exploring an alliance with the Mexican Consulate. Marina regularly seeks input from colleagues across the organization, partners and the broader community to ensure they are focused on their right areas and tactics, to assess with is working, and to brainstorm solutions to overcome barriers. Where she identifies critical support gaps that cannot be addressed through partnership, L.A. Care is committed to developing solutions to close those gaps, but building strong partnerships has thus far been a fruitful strategic shift.

Our experts have sifted through volumes of literature on social determinants of health, and have pulled together a concise digest that contains the Advisory Board’s take on how health plans should address social determinants, plus an overview of publications that are worth a skim.