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Health-Related Social Needs are Prevalent Among Commercially Insured

January 25, 2024

Conversations about and screenings for health-related social needs (HRSN) are often focused on people with Medicare and/or Medicaid coverage. Meanwhile, HRSN data for commercially insured populations — who make up approximately two-thirds of the U.S. adult population — are typically inferred from area-level data that lack the precision necessary to assess an individual’s health-related needs. 

A novel study by Elevance Health and Carelon Research teams has found that while commercially insured adults are the least likely to be surveyed for HRSNs, a large proportion have such needs. The study also found that increasing numbers of HRSNs were correlated with worse health outcomes and higher healthcare costs.

Findings: HRSNs (e.g., health access, social support, financial strain) were shown to be prevalent among commercially insured adults, putting them at significantly higher risk for worse health, even after controlling for income and demographic characteristics.

In the study, 76% of people with commercial health plans reported having at least one HRSN, and nearly 30% reported having more than three. One in three commercially insured members report experiencing financial strain, and one in five report food insecurity.

Researchers also found that commercially insured people who report HRSNs have more self-reported physically and mentally unhealthy days, a higher prevalence of anxiety/depression and hypertension, more emergency room visits, and higher healthcare costs. These findings are consistent with results from other surveys of HRSNs among non-commercially insured U.S. adults.

What’s Next: Collaboration between providers and health plans to collect HRSN data would increase the frequency and likelihood of all individuals — including commercially insured members — being assessed for HRSNs and that data being used when coordinating a care plan. Furthermore, creating a common set of standards for and definitions of HRSNs would allow data collected at different patient interaction points to be shared and integrated into the delivery of healthcare. Elevance Health and its family of brands have teamed up with employers, providers, and community-based organizations (CBOs) to proactively assess and address HRSNs through various programs and products.

Methodology: This cross-sectional study used data from a representative sample of 1,160 adults residing in Georgia and Indiana who have commercial health plans affiliated with Elevance Health. Respondents completed a survey online or over the telephone with an interviewer between December 2021 and March 2022. The survey asked questions associated with the HRSN domains of healthcare access, financial well-being, internet access, housing quality, healthy food access, interpersonal safety, housing stability, reliable transportation, and social support.

Respondent survey data were subsequently linked to Elevance Health medical and pharmacy claims data to analyze health outcomes and spending. A stratified quota probability sampling strategy was developed and implemented for each state to ensure survey respondents were representative of commercial health plan membership by gender, age, social vulnerability index ranking, and where they live in relation to a city center (urban, suburban, rural).

Read the Study:

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