Recently, health insurers have begun focusing on social determinants of health (SDOH) and the role these factors play on health outcomes. Then the COVID-19 pandemic put even more of a spotlight on the issue, disproportionately affecting people of color and low-income communities. Recognizing the impact that SDOH can have, AllianceRx Walgreens Prime is partnering with Highmark Inc. to launch a pilot outreach program focused on the impact of SDOH on people with multiple sclerosis (MS), AIS Health reported.

The program will apply to Highmark members with an MS diagnosis who use AllianceRx Walgreens Prime as their specialty pharmacy. To participate, these members must be willing to take part in a 13-question, voluntary survey conducted via telephone. SDOH-trained nurses from AllianceRx Walgreens Prime are contacting eligible members by phone and offering to administer the survey. Highmark will assess the survey responses to identify how it can design a specific care plan for each member facing SDOH challenges.

“Based on the self-identified needs of the member, the Highmark Social Work team will outreach to further assess the SDOH issue or barriers,” explains Amy Shannon, director of health and wellbeing integration at Highmark.

“SDOH can drive up to 80% of an individual’s health outcomes,” she says. “It’s imperative that we assess and provide support to members who are facing SDOH issues.”

According to Rick Miller, BS.Pharm., MS.Pharm., vice president of clinical and professional services at AllianceRx Walgreens Prime, the pilot is focusing on seven domains: “social connections, financial resource strain, health literacy, food insecurity, transportation needs, safety and housing stability. While these SDOH domains may impact any patient with a health condition, in the short time the pilot has been live, we have already identified transportation needs, housing stability and financial resource strain as concerns within the MS population.”

The program will run for one year. Depending on its success, additional patient populations may be included in future phases. “We are exploring a number of specialty disease states for future expansion,” says Miller. “Initial expansion would focus on chronic specialty therapies, as well as specialty disease states, such as oncology and autoimmune diseases, that can be complex and challenging for patients to navigate through the health care system.”

by Angela Maas