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Without a place to call home and caught in a familiar and unwanted cycle of emergency room visits and hospitalizations, James Bastel didn’t eat regularly and wasn’t able to consistently take his medications. His health-related social needs also got in the way of his ability to establish a regular relationship with a doctor or clinic.  

During one of his hospitalizations, James heard from Tina, an Elevance Health case manager. She helped James break the cycle by helping him get behavioral health treatment and other supports he needed. What worked to get James on a healthier path sheds light on how the health system could work better for all of us.

When everyone has an equal chance to be as healthy as they can be, society and individuals benefit. Sometimes unmet health-related social needs and behavioral health needs stand in the way of physical health. We believe in this concept so strongly that we have grounded our health company’s business and health strategy around it.

A business grounded in a whole-health approach

About 20 percent of health outcomes and associated costs are tied to traditional physical healthcare needs, such as treating high blood pressure in a health clinic.  A lack of nutritious food, stable housing, social support or an ability to access healthcare drives the other 80 percent; these kinds of barriers to care are known as unmet health-related social and behavioral health needs.

About 75 percent of the people who are members of Elevance Health-affiliated Medicaid health plans have multiple health-related social needs, and each unmet need drives up their healthcare costs¹ by about $1,500 per year. Importantly, this detracts from their health and overall well-being because these health-related social needs are highly associated with anxiety and depression, emergency department use, preventable hospitalization and more unhealthy days (as defined by the Centers for Disease Control and Prevention).

These are just a few reasons why Elevance Health has shifted our health strategy to focus on addressing a person’s whole health—the physical, behavioral, and social health of all members. Data allows us to see which aspects of these primary health drivers offer the greatest opportunity to improve the health of the people and communities we serve. We can then help facilitate access to the needed resources to address those drivers.

Providing doulas, nutritious food, better medical care in rural areas

For example, an increasing percentage of pregnant women are not able to access care providers and may have living and working conditions that present barriers to regular prenatal care, leading to adverse health outcomes for themselves and their babies. So we’ve included access to doulas  in our Medicaid programs. The result is that women have fewer inpatient hospital admissions during pregnancy, are more likely to attend their postnatal visit, experience lower odds of cesarean delivery, have lower odds of postpartum depression or anxiety and have lower overall costs compared to women not using doulas. Data shows some women, especially Black and Hispanic/Latino women, feel they are treated better and more holistically when doulas are present.

Many people who live in rural areas across the country are not able to visit care providers in person due to geographical distance. About 45 million people in the United States, or 15 percent of the population, live in areas designated as health professional shortage areas (HPSA) by the federal government. By partnering with community-based organizations and providers, we are working to make more care providers available through telehealth and mobile services.

We also created Community Connected Care, which seeks to assess and address health-related social needs by collaborating with community-based organizations (CBOs), such as food banks and other non-profits like area agencies on aging, centers for independent living and Boys & Girls Clubs. This means we create partnerships with CBOs to provide needed infrastructure support and resources that build capacity through a managed care approach.

In one partnership that spans 21 states, for example, we’ve been able to reinvest more than 60 cents of every dollar our health plan spent on the program into the community-based organizations that are serving our members.

  • In one year, we have referred more than 200,000 members to offer solutions spanning community resources, health plan products and benefits, or customized interventions.
  • Today, this program is available to individuals in the 14 states where we offer plans under the Affordable Care Act. Our data shows that 30 percent of these members have multiple unmet health-related social needs.
  • By 2024, this program will be available to many of our Medicare plans. 
  • The program is financially sustainable because over time it focuses on prevention as a priority, replacing and lowering other healthcare costs.

When we take a broader view by considering and acting on all the drivers of health, we can improve outcomes and the bottom line. It’s not just generally the right thing to do. It’s the right thing to do for our members, our business, and the health system.


1. Elevance Health Social Risk Survey Data.

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