Highmark program links social services to improved health care and reduced costs

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Thanks to a recent trial program, Highmark Health said it has been able to show that its Social Care Network program can deliver significant improvements to patient care while reducing costs. 

 Nebeyou Abebe, senior vice president, Social Health at Highmark Health said the initiative represents one of the nation’s first scalable models to seamlessly integrate social care directly within a health system showing the correlation improved health outcomes and substantial cost reductions. 

He used Maslow’s hierarchy of needs to illustrate how the program works. 

“We need to meet their most basic needs before they can engage in their health care,” Abebe said. 

The program addresses basic needs that might be interfering with a person’s ability to seek proper preventative health care such as a lack of transportation or food or housing insecurity. 

Highmark Health and Allegheny Health Network (AHN) launched the Social Care Network pilot in July 2022. 

Highmark surveyed users to see if they have any critical needs and if they do they linked them to social service providers they had contracted with in the area. The providers would then report back to Highmark that services were rendered. 

“They are being financially compensated, and we keep them in the loop that services are being provided,” Abebe said. 

Abebe explained that program incentivizes CBOs for successfully addressing critical social determinants of health, which are known to impact up to 80% of an individual’s health. 

Abebe said that one of the benefits of the trial is that it generated data that highlighted the effectiveness of Highmark Health’s Social Care Network. 

The data showed that when people were referred through Highmark Health’s Social Care Network, 85% of the referrals had a closed communication, compared to referrals to out-of-network organizations seeing a 24% closed communication rate. 

Overall, 27% of all referrals made through Highmark Health’s Social Care Network led to members getting assistance, compared with 17% of referrals outside of the network.  

Abebe said the impact on costs and care utilization was also significant. 

People who received social care services through Highmark Health’s Social Care Network had, on average, $617 less in medical costs per month. 

Hospital admissions dropped by 26 inpatient stays per 1,000 members per month. 

Abebe said those savings and reductions in high-intensity care continued for at least one year after people received services, indicating that the program has lasting impact and is financially sustainable. 

“Highmark Health is proud to lead the way in demonstrating how health systems can effectively collaborate with communities to enact sustaining change. The data clearly shows that when we connect people to vital social support, we see direct, significant reductions in health care costs and improved health outcomes for our members,” said Amit Kale, vice president of Social Health for Highmark Health. 

The original pilot program was supported by a grant from the Richard King Mellon Foundation.  

Building on its early success, the program has since expanded to include a network of more than 30 community-based organizations (CBOs) serving western Pennsylvania and West Virginia. 

There are plans in the works to expand the program into Central Pennsylvania and the Lehigh Valley in the future. 

“For Highmark Health, Social Health is a critical enterprise priority, deeply integrated into every facet of our operations,” said Abebe. “By tackling the foundational drivers of health, we believe we can achieve better health outcomes and a more sustainable, effective health care system for all.”