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UnitedHealthcare and AMA unite to address social determinants of health

The duo is supporting the creation of nearly two dozen new ICD-10 codes related to social determinants of health.

UnitedHealthcare and the American Medical Association are working together on an initiative aimed at standardizing how information regarding social and environmental factors is collected, processed and integrated.

Together, they’re supporting the creation of almost 24 new ICD-10 codes related to social determinants of health. They’re bringing together medical data with self-reported SDOH information, and the ICD-10 codes trigger referrals to services that connect patients to resources in their communities.

“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 healthcare,” UnitedHealthcare president of clinical services Bill Hagan said in a statement.

The duo is building on the work begun by UnitedHealthcare. The insurer has developed a data model focused on capturing social determinants-related information. Through the model, UHC said it has made more than 700,000 social service referrals for individuals in its Medicare Advantage plans since 2017.

The American Medical Association is contributing through its Integrated Health Model Initiative, which is working to ensure data portability standards and interoperability are achievable.

“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,” Tom Giannulli, chief medical information officer of AHA’s IHMI, said in a statement.

UnitedHealthcare and the AMA aren’t the only organizations zeroing in on SDOH.

For instance, the Blue Cross Blue Shield Institute recently paired up with Solera Health to take on the same topic. Based in Phoenix, Solera connects patients with community-based and digital programs. It also facilities their reimbursement through the medical claims process.

Additionally, CMS has expanded the ability of Medicare Advantage plans to tackle social determinants of health for the chronically ill.

Photo: mattjiecock, Getty Images

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