Investing in health equity

Employers take on SDoH through analytics

Published January 24, 2020

It's exciting to be part of the Aetna team that is working to enable plan sponsors (employers) to understand and tackle social determinants of health (SDoH). Our goal is to deliver results at scale (for the first time in the industry) in a differentiating way and through a personal passion of mine — analytics. In a 2019 announcement, "Destination: Health," a New Platform Addressing Social Determinants of Health, Aetna referenced some work underway — collaborating with plan sponsors, using our powerful analytics capabilities and applying our Health Equity framework. Then, using an ROI-based approach, that information helped us identify, quantify and address barriers to good health driven by social determinants within employer environments.

Given the traction we are seeing, I thought I would share more about this. Our Health Equity framework provides a structured approach for plan sponsors to take action on SDoH-based disparities in employee health outcomes. We do this in a deliberate and repeatable way:

• Leverage new analytics, organizing disparity analytics into actionable groupings
• Investigate root causes to understand what’s driving member actions
• Focus on top opportunities based on ROI to the plan sponsor
• Target best actions by engaging all stakeholders

I’ve been working with customers using this approach for some time. The root-cause investigations in particular have provided interesting insights. We repeatedly find the same classes of behavior drivers leading to disparities:

• Awareness — members do not know about a program or plan design feature (“are urgent care centers covered by my plan?”)
• Access — members know about a program feature but are not able to get to it (“my son’s pediatrician’s office closes at 5:00 but my shift does not end until 7:00”)
• Affordability — the care or service is cost prohibitive (“with all the other bills I have, I can’t afford to get my prescription filled”)

As we’ve teamed up with our customers, we’ve been able to use our framework to measure, organize and share insights internally throughout their organizations and also with potential community partners. SDoH analytics have become a powerful way to generate and sustain the internal conversation with a broader set of stakeholders. This opens up new options for creative problem solving. With engaged internal and local partners suggesting more options within their control, a greater number of strategies and tactics for tackling the issues surfaced. Ultimately, with more options, we can be more selective about where we start and focus efforts. Reaping the benefits of “high value, high return” first reinforces internal interest and builds momentum for sustained impact, providing a metrics-driven pathway for plan sponsors to engage with (and take action on) lowering program costs and improving the health of the workforce.

So how are we able to measure disparities? Aetna provides specialized analytics that allow employers to look at this complicated set of issues, including financial burden and risk, through a business lens. We create transparency around how social determinants may be influencing engagement, utilization and costs through the use of ART, our new “point and click” analytics platform, and an embedded SDoH Index score. The SDoH Index, assigned to each member, is based on sophisticated and proprietary data science work in this area, but we’ve made it easy for customers to find insights using the SDoH Index in their own population. Social determinants analytics are being developed and deployed for any Aetna plan sponsor using ART.

With these SDoH analytics, we are empowering employers to not only measure likely SDoH-driven disparities but also assess the costs of these disparities. The remaining work is to understand, at both the local and company-wide level, what the specific needs look like for each employer, determine the best way to dissolve the barriers, and implement solutions.

If you are, like me, passionate about creating health equity and want to understand more about how you can use analytics to initiate meaningful change within your organization, read the Aetna white paper Healthy equity for working Americans. And tell your story if your organization has found a way forward that delivers noticeable health and financial results by taking steps toward health equity — these are great accomplishments we need to share!

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