It is widely accepted that social determinants of health (SDOH), such as socioeconomic status, education, employment, and more, often have a greater impact on people’s health than even clinical care. Therefore, more and more health plans are starting their own initiatives to address SDOH in 2020.

But when health plans are first planning their SDOH strategy, many make this common mistake—they waste their resources on redundant initiatives. This can occur internally if multiple departments are working on SDOH initiatives in silos, especially as most plans don’t have a department solely dedicated to SDOH yet. This can also occur externally if plans are starting SDOH programs from scratch when there are already local community based organizations (CBOs) that already have similar programs in place.

Read on to see how Inland Empire Health Plan (IEHP), a 1.2 million member Medicaid managed care plan in California, strategically invested to avoid wasting their resources on redundant initiatives both internally and externally.

Coordinate SDOH initiatives internally to play to each department’s strengths

IEHP decided to separate their SDOH initiatives between their marketing and health services departments. Even though these initiatives are run by separate departments, they are in constant communication to make sure each department knows what is in their jurisdiction. Previously, all SDOH initiatives came from the marketing department but IEHP decided to transition some of these initiatives to health services, while remaining collaborative, due to three main differences between the two departments:

    1.    Metrics and goals

             The two departments are judged on different metrics, which changes the goals of the SDOH                 investments. For example, marketing would want to increase new member enrollment whereas                 health services would want to decrease total cost of care for current members.

    2.    Target populations
                The two departments would be targeting completely different subpopulations with their SDOH                 investments. For example, marketing might want to target senior non-members for a new                 Medicare Advantage product launch while health services might want to target the housing                 unstable member population for a certain initiative.

    3.    Strengths
                The two departments have very different strengths that they should take advantage of when                         delivering SDOH initiatives. For example, marketing should oversee SDOH initiatives for                                         non-members because they best understand CMS rules on what can and cannot be given                 to non-members.

Empower CBOs’ existing initiatives to efficiently scale SDOH services

Rather than creating completely new SDOH pilots, IEHP actively empowers local CBOs and their pre-existing initiatives. IEHP created specific metrics for high-performing CBOs and chooses to partner with CBOs that meet these metrics or show a commitment to meet these metrics. These CBO partners are privy to the many ways IEHP lends its expertise to increase CBO capacity, such as:

    1.    Research on evidence based programs

                IEHP has a robust evaluation department that identifies evidence based programs and                 recommends them to the plan, providers, and CBOs. Their newest area of research is in the area             of  Adverse Childhood Experiences (ACE) assessment and interventions. Most CBOs do not have             the bandwidth to conduct this type of research themselves, so they’re thankful for the             professional help from IEHP that is tailored to a CBO’s specific proposal to IEHP.

    2.    Meetings with other CBO leaders to share best practices

                IEHP coordinates quarterly meetings with hundreds of CBO leaders so that they can share best                 practices and learn from each other. For example, the CBOs learned that it takes about 10                 engagements with a member before they actually accept a housing offer. The CBOs enjoy the                 comradery and the meal and are really appreciative to IEHP for hosting these events.

    3.    Plan outreach representatives support CBOs

                Plan outreach representatives serve CBOs similar to how plan provider representatives serve                 providers. They are experts in specific SDOHs such as childhood prevention programs, housing                 instability, and more. These reps are able to have in-depth, frequent conversations about the                 CBO’s specific challenges and how IEHP can support them.