UnitedHealthcare is harnessing predictive analytics to more effectively address members’ social determinants of health.
The health insurance giant has rolled out the program to employers who have selected the Advocate4Me Elite and Advocate4Me Premier products, with plans to launch it for fully insured employer plans later this year, according to an announcement.
The tool uses de-indentified claims data to proactively identify members who may be at greatest risk for social concerns. The insurer’s call center advocates are then armed with a curated database of community resources to assist members with their social needs.
“When we are looking at our population, we want to make sure we are addressing all of the variables to help support our members,” Rebecca Madsen, UnitedHealthcare’s chief consumer officer, told Fierce Healthcare.
The predictive model was developed alongside Optum. Finding ways to combine the strengths of both arms of the company is a key strategic goal for executives at UnitedHealth Group.
The tool assess data from 300 markets and across 100 metrics, UnitedHealthcare said. It’s also designed to allow employers to design interventions that may best meet the needs of their workers.
In addition, the insurer is training its call center teams to recognize certain keywords that can indicate social health challenges. If a member says things like “I’m hungry” or “I’m struggling to make ends meet” on a call, even if they were not flagged by the data as being at risk, the call center staffer can proactively connect them with resources.
Madsen said call center staff are also equipped with a questionnaire they can use to ensure that the conversation about a member’s social needs continues beyond that initial call.
Resources include assistance with childcare or medical bills, help obtaining internet access and a connection to local support groups or healthy food options. So far, half of eligible individuals have accepted assistance with their social needs, UnitedHealthcare said.
“This is just a really positive indicator of the fact that people want the support,” Madsen said.