UnitedHealthcare and the AMA Collaborate on SDOH to Improve Access and Outcomes

April 2, 2019
Leaders at UnitedHealthcare and at the AMA’s Integrated Health Model Initiative have announced a collaboration to identify social determinants of health data that could improve care access and outcomes

The Edina, Minn.-based UnitedHealthcare, a UnitedHealth Group company, and the Chicago-based American Medical Association (AMA), on April 2 announced a new collaboration that will better identify and address social determinants of health (SDOH) to improve access to care and patient outcomes.  

“Building on work initiated by UnitedHealthcare, the two organizations are working together to standardize how data is collected, processed and integrated regarding critical social and environmental factors that contribute to patient well-being. Through this collaboration, UnitedHealthcare and the AMA are supporting the creation of nearly two dozen new ICD-10 codes related to SDOH,” UnitedHealthcare executives announced via a press release. “By combining traditional medical data with self-reported SDOH data, the codes trigger referrals to social and government services to address people’s unique needs, connecting them directly to local and national resources in their communities.”

“UnitedHealthcare and the AMA share a common goal of expanding the health care system’s perspective to consider the whole person – not just medical care – by placing as much emphasis on people’s social needs as on their clinical needs,” said Bill Hagan, president, clinical services, UnitedHealthcare, in a statement contained in the April 2 press release. “By working together to leverage data, technology and the incredible expertise of our network physicians, we can more effectively address the social factors that limit access to health care.”

And the AMA’s Tom Giannulli, chief medical information officer of the AMA’s  Integrated Health Model Initiative, or IHMI, said in a statement contained in that press release, that “The AMA is excited to work with UnitedHealthcare through the continuing efforts of our Integrated Health Model Initiative (IHMI) to foster collaboration around innovative data and technology-driven processes for incorporating social determinants of health into routine medical care. The collaboration reinforces the importance of social and environmental factors in patient care, and will shape IHMI’s efforts to support clinical decisions with useful and valid data to achieve broad improvements in health and greater health equity.”

The work at UnitedHealthcare that led to this announced collaboration, was described in detail in the profile of the team of leaders from the health plan whose work led to their being named the number-three winning team in the Healthcare Innovation Innovator Awards Program this year. As Editor-in-Chief Mark Hagland noted in the article about that team, the goal of that team’s work was to “create the first-of-its-kind, industry-wide model that would standardize and integrate consumer self-identified social determinants of health (SDOH) barriers allowing for referral assistance and outcome measurement at scale. With that goal in mind, UHC leaders in 2017 began a nationwide initiative to capture, code, and refer to social/governmental programs members who self-identified SDOH,” he wrote.

Typically, Tuesday’s press release noted, physicians and care providers use a system of ICD-10 codes to classify and record all diagnoses, symptoms, and medical treatments and procedures. UnitedHealthcare has developed a data model focused on standardizing the capture and processing of SDOH-related information.

According to the press release, “The AMA’s IHMI group is dedicated to ensuring that data portability standards and semantic interoperability are openly achievable and keep pace with innovation. Its work continues to focus on market-driven needs in health care data interoperability through the development of common data portability standards that enhance information sharing and unlock potential improvements in patient outcomes.”