AMA and UnitedHealth Bring Social Determinants of Health into Healthcare Delivery with ICD-10 Codes

ANCOR is sharing this story by HealthLeaders because the private and public sectors are increasingly becoming aware and seeking to address the role of social determinants of health in improving health care. This is relevant to people with disabilities, as many factors outside their control could affect their health, such as the fact that people with disabilities are more likely to experience challenges to related to poverty, housing instability and lack of transportation than their peers without disabilities.

As shared by HealthLeaders:

“UnitedHealthcare, and the American Medical Association have launched a collaboration to create nearly two dozen ICD-10 codes to better incorporate social determinants of health [SDOH] into healthcare delivery.

The collaborative wants to standardize how SDOH such as food, housing, transportation, employment, and financial means are collected, processed and used in patients’ care plans, noting that there exists no consistent, organized method to capture that data.

By combining traditional medical data with self-reported SDOH data, the codes trigger referrals to social and government services to address people’s unique needs, connecting them directly to local and national resources in their communities, the collaborative said in a media release.

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Using its data model, UnitedHealthcare said it has made more than 700,000 social-service referrals for enrollees in its Medicare Advantage plans since 2017.

Increasingly, payers, providers, and state and federal governments are acknowledging the critical role that SDOH plays in proactive care delivery.

In 2016, CMS amended the Medicaid managed care rule to prompt Medicaid MCOs to help patients with nonmedical expenses that were considered crucial to achieving health outcomes and cutting costs.

Under the CMS Accountable Health Communities Initiative, many Medicaid MCOs assess patients’ unmet social needs, including housing instability, food insecurity, utility needs, interpersonal violence, and transportation requirements.”