Highmark Health Publishes Data on Value of SDOH Network

Highmark Health’s Social Care Network has expanded to 30 community-based organizations (CBOs) serving western Pennsylvania and West Virginia. The integrated healthcare delivery and financing system recently released data on the network’s impact. 

Highmark Health and Allegheny Health Network launched the Social Care Network with a pilot in July 2022. The program incentivizes CBOs for successfully addressing social determinants of health (SDOH) such as food insecurity, housing instability, and lack of access to transportation. 

Highmark researchers published findings in Health Affairs Scholar about the effectiveness of the Social Care Network:
• When people were referred through Highmark Health’s Social Care Network, 85% of the referrals had a closed communication, compared to referrals to out-of-network organizations seeing a 24% closed communication rate.
• Overall, 27% of all referrals made through Highmark Health’s Social Care Network led to members getting assistance, compared with 17% of referrals outside of the network. 

The impact on costs and care utilization was also significant:
• People who received social care services through Highmark Health’s Social Care Network had, on average, $617 less in medical costs per month.

• Hospital admissions dropped by 26 inpatient stays per 1,000 members per month.

• These savings and reductions in high-intensity care continued for at least one year after people received services, indicating that the program has lasting impact and is financially sustainable.

"Highmark Health is proud to lead the way in demonstrating how health systems can effectively collaborate with communities to enact sustaining change. The data clearly shows that when we connect people to vital social support, we see direct, significant reductions in health care costs and improved health outcomes for our members," said Amit Kale, M.D., M.H.A., vice president of social health for Highmark Health, in a statement.

Pittsburgh-based Highmark added that while broad investment in social care is increasing, few models have achieved this level of measurable, scalable and sustainable integration within health systems.

The original pilot program, from which the data in this study was derived, was supported by a grant from the Richard King Mellon Foundation. Following the success of the Social Care Network in Pennsylvania, the health plan further scaled this model in 2024, expanding its reach to serve Medicaid members across all 55 counties in West Virginia.

As part of Highmark Health’s program, its clinical staff refers individuals to social care services with participating community-based organizations through its Community Support Platform and closely monitors each individual’s journey.