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Investing in health equity

Learn more about how we’re helping plan sponsors identify and address disparities in their workforce.

Pilot studies on social determinants of health


Published February 7, 2020


Andy Hiles


Vice President, Plan Sponsor Insights & Health Equity Solutions, Aetna®


The pilots we are doing at Aetna to address the social determinants of health (SDoH) impacting workers — at scale in both the commercial and the plan sponsor community — are the first of their kind. We are executing 10 pilots and applying our Health Equity framework to dissolve barriers to health and reduce costs driven by SDoH. We recognize that employers are a community — they construct and control environments in which people spend 8 to 10 hours of their day, a tangible manifestation of the very definition of SDoH.


In a sense, these pilots are the next evolution of thinking around social determinants. We stand on the shoulders of those researchers and public health workers who tirelessly engage with local communities to improve health and quality of life in our cities and towns. Aetna, a CVS Health® company, is very active in the public health arena, and we applaud our colleagues for the enormous contributions they make. On my team, we are extending that passion to address social determinants to plan sponsors with new tools, analytics and solutions. For us, each employer is a community of workers to be engaged and supported as they strive to achieve their best health. 


In collaboration with a select group of highly innovative employers, we are executing a number of pilot studies across an intentionally diverse set of industries and geographies. We are also studying populations within several specific geographic markets and aggregating plan sponsor data sets to gain a cross-sectional view.


Even before we established formal customer and market pilots, we found that social determinants have a powerful impact on health. We found that if not addressed, social determinants create barriers to employee health, resulting in higher costs for employees and plan sponsors. We quantified this in Aetna commercial data, further validating external studies like this one from the Commonwealth Fund: How Well Does Insurance Coverage Protect Consumers from Health Care Costs?


In the pilot studies, we are investigating three things: where are the health disparities in the plan sponsor’s data, what are the social and financial barriers workers face that cause these disparities, and what levers can we apply — in partnership with the plan sponsor, network providers and community organizations — to deliver concrete solutions with the highest ROI. We are making good progress in all three areas.


Who are we studying?


Unlike much of the research and literature about social determinants, which is focused on public health issues, we are addressing the challenges facing working Americans in the commercial segment. This population is well enough to be employed in stable, full-time positions at companies that offer health benefits. And yet their life circumstances create barriers to good health based on recognized social and economic factors. So, when we talk about social determinants, we include total household income, transportation, education and other factors known to affect health outcomes and the efficacy of interactions with the health care system. These are “the conditions in which people live, work, learn and play.”


As an employer sponsoring a health plan for your employees, you play a major role in influencing these conditions. Consider this lens, or expanded view of your role, given that you also bear a significant portion of the costs and risks associated with employee health. You are uniquely positioned to address social determinants with deliberate strategies, program design and measurable results. That’s what our analytics-based approach lets you communicate to your organization. It builds the case to invest or collaborate for change with measured returns on costs. It’s a great way to encourage others to achieve health equity, with a win for everyone.


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