The Covid-19 pandemic is accelerating employers' efforts to address social determinants of health with their benefit packages, but data collection has to be the first step for employers serious about tackling those needs, according to a new report by a Manhattan-based coalition.
Employers pay for health care coverage for more than half the U.S. population, so they have "too much at stake not to pay more attention" to social determinants of health, said the report released Tuesday by Northeast Business Group on Health, an employer-led coalition of benefits leaders and health care stakeholders.
"Covid and some of the disparities we have seen in outcomes have really shone a light on the impact of social determinants of health," Northeast Business Group on Health CEO Candice Sherman said. "I think now there's a greater urgency to continue working to find new ways of addressing them and solutions."
The group, which compiled the report using a $100,000 grant from Mother Cabrini Health Foundation, said a key hurdle that employers must first overcome is the lack of data on social determinants of health beyond a population level.
One solution is the implementation of screening tools to collect employee data on needs and risk factors, but the report cautions that any surveys should be anonymized to guard individual privacy.
Employers can also collaborate with their health plans and existing vendors or partner with local hospitals to harness data they have already collected. Northwell Health is working to obtain data on social determinants of health during patients' clinical consultations. Montefiore Health System has a survey tool that asks patients about their concerns regarding the stability and quality of their housing, food access, transportation and other social needs.
Insurance carrier UnitedHealthcare launched a predictive analytics program last year to help select employers identify enrollees who could benefit from resources related to social determinants of health. Rebecca Madsen, chief consumer officer for UnitedHealthcare, said eligible members have accepted more than 50% of offers for support.
"We are seeing a growing interest among employers across the country, including in New York, to address social determinants of health needs among their employees, such as lack of affordable housing, nutritious food or internet access," Madsen said.
Sherman said employers should also take a holistic look at the benefits they are providing and add a menu of options related to social determinants of health. She cited as examples two member employers that offer food deliveries as a benefit, one through weekly boxes of fresh produce and another through food-delivery platform DoorDash. Tuition assistance, transportation subsidies and health literacy programs are other benefits that can address employees' common social needs.
Employers can also rework their paid time off policies to include caregiving benefits, such as dedicated leave and care navigation services, the report said.
Once employers identify benefits to add to their packages, platforms like Unite Us, a Manhattan-based health tech startup, can facilitate connections to local social services providers.
Health plans have already integrated solutions like Unite Us, but Sherman said employers should let their insurance carriers know that social determinants of health are a priority.
"That will serve as an impetus for innovation," she said.
Northeast Business Group on Health is based in the Financial District and has 229 members. It was founded in 1982. —Maya Kaufman
The COVID-19 pandemic has spotlighted social challenges that impact health, and the Northeast Business Group on Health (NEBGH) is issuing a new guide that aims to help employers address such issues among their workforces.
The guidebook takes a deep dive into five key social determinants of health: economic stability; education access; healthcare access; neighborhood and built environment; and community. It then offers a step-by-step process for employers to follow if they want to get serious about addressing these issues.
Candice Sherman, CEO of NEBGH, told Fierce Healthcare that the group has been fielding an increasing number of questions from its members about social needs, which prompted the guide's development.
Despite the many challenges that can hinder progress on social determinants of health, employer social determinants of health strategies can profoundly impact employees’ families and communities, according to a report from the Northeast Business Group on Health.
There are several steps that the Northeast Business Group on Health identified as crucial for employers looking to engage in employees’ social risks and social determinants of health.
According to the Northeast Business Group on Health, mental health conditions are a leading cause of employee absences (major depressive disorders cause 27 yearly absences and bipolar disorder causes 66 yearly absences on average). However, clinically validated mental health treatment has been found to dramatically reduce employee absenteeism, which can result in a savings for employers of $2 to $4 for every dollar they invest in mental health benefits.
Shatterproof, a national nonprofit organization dedicated to reversing the addiction crisis in the United States, has announced the formation of the National Addiction Treatment Quality Committee (NATQC). The NATQC is comprised of a diverse group of industry experts convened by Shatterproof, representing federal and state agencies, addiction treatment providers, health systems, consumer advocacy groups, academic institutions, healthcare payers and purchasers, and individuals with lived experience of addiction.
This group is charged with providing guidance and recommendations on quality measures and enhancements to Shatterproof’s Addiction Treatment Locator, Assessment and Standards (ATLAS®) platform, which aims to empower the public to find high-quality treatment services and ultimately drive the delivery of quality addiction treatment nationally. In addition, the NATQC will further existing quality work in the addiction treatment space to ensure quality measures reflect the contemporary needs and landscape of addiction treatment in the U.S. Work by the NATQC builds on the existing efforts of state-based ATLAS advisory committees and the Shatterproof Substance Use Disorder Treatment Task Force.
We’re seeing an increase in the number of partnerships forming in the benefits and retirement arena this second half of 2021. Companies with expertise in those areas are working with technology companies to make benefits and financial platforms and dashboards for employers, employees, and advisors. What effects might we see from such partnerships, beyond the immediate products offered? At the least, perhaps, a greater awareness of the value of a good user experience in delivering what is often complicated financial and insurance information.
Health care purchasing experts tell AIS Health that employers are beginning to realize that high-deductible plans have deep flaws. “More and more of the data seems to show that there are some unintended negative consequences from high-deductible health plans, especially for lower-income employees,” Candice Sherman, CEO of the Northeast Business Group on Health (NEBGH), tells AIS Health. NEBGH is a purchaser group whose members include large firms, such as Comcast Corp. and Verizon Inc., unions and public employee plans. Its members also include the nation’s largest health insurance carriers: UnitedHealthcare, CVS Health Corp. and its Aetna arm, Anthem, Inc., and Cigna Corp. “There’s been some loosening up of the regulations that allows some first-dollar coverage for high-value classes of medications and services, which is certainly helpful. But I do think that [plan sponsors] are looking at high-deductible plans a little bit more closely,” Sherman says. She points out that high deductibles can deter patients from accessing necessary care. Sherman says plan sponsors have begun to revamp their benefit offerings to address diversity, equity and inclusion concerns over the last year — and points out that high-deductible plans’ deterrent effects are disproportionately harmful to people of color, who generally have less household wealth than white people due to institutional racism. “I think the issue of equity versus equality is an interesting issue to contemplate when it comes to these kinds of things,” Sherman points out. “We may have a desire to treat everyone equally. But what does that mean in terms of people’s ability to actually access and receive quality health care?”
In the early 2000s, The Trust made a series of grants to the Alliance to advocate for insurance reimbursement parity for mental health, which resulted in the federal Mental Health Parity and Addiction Equity Act of 2008. With the passage of the federal Affordable Care Act in 2010, much of The Trust’s work in mental health in the decade that followed included grants to nonprofits such as the Coalition for Behavioral Health, to help mental-health clinics acclimatize to Medicaid expansion, secure better reimbursement rates, and adapt to the world of managed care.
In 2020, The Trust sought to expand insurance parity with a grant to the Northeast Business Group on Health to be part of a national drive to improve behavioral health care access for people with employer-sponsored insurance. To guide systemic change, The Trust made a grant to the Bipartisan Policy Center for a 2021 report on integrating primary health care and mental health care and to promote its recommendations to improve care in New York and nationally.
Employers weighing whether to follow Delta Air Lines’ lead and impose financial penalties on their unvaccinated employees could charge an unlimited amount depending on the type of wellness plan they choose.
Other companies will “probably watch and see what negative impact Delta has from doing that,” Mark Cunningham-Hill, medical director of the Northeast Business Group on Health, said of the surcharge. The NBGH, which represents employers on health plan issues, has about 170 member companies covering 6 million to 7 million people in New York, New Jersey, and Connecticut.
The chief concern would be losing employees in the tight labor market, he said.
“Delta is ahead of the curve on this one.”