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UnitedHealthcare is using predictive analytics, developed with Optum, to address the social determinants

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UnitedHealthcare has introduced the use of predictive analytics for employer-sponsored plans to help identify people in need of support related to the social determinants of health. 

Developed in collaboration with Optum, the UnitedHealthcare capability can help employers predict the likelihood that their employees may have a need for a social intervention, assessing more than 300 markets across the country and analyzing over 100 metrics. 

The new capability uses de-identified claims data from more than 100 million UnitedHealthcare members. Through analytics and aggregate claims data, employers can design and implement healthcare strategies to identify the need for support. 

The resource is currently available to employers who select UnitedHealthcare’s Advocate4Me Elite or Advocate4Me Premier product offerings, with plans to introduce a customized version for employers with fully insured health benefits later this year. 

UnitedHealthcare call center advocates use real-time interactions coupled with a curated database of community resources to help individuals.

UnitedHealthcare call center staff are trained to listen for key words, such as “I’m hungry,” “I’m having trouble making ends meet,” or “I’m stressed,” and then proactively connect the individual to low- or no-cost community resources, UHC said. 

They help people find access to meals through resources such as local food banks; obtain internet or smartphone access through financial subsidies offered by telecommunications companies; find local support groups, including for continuing education and mentoring; and obtain assistance for rent or mortgage, child care or utility bills.

The recommended resources have been evaluated and vetted as providing quality, cost-effective services, UHC said. Since introducing the capability, eligible individuals have accepted over 50% of the offers for support.


The targeted support model is intended to help eliminate barriers to well-being, diminish out-of-pocket consumer costs and avoid potential expenses for employers.

Predictive analytics can drive engagement in clinical intervention programs, UHC said.

The new capability builds on similar initiatives for UnitedHealthcare Medicare and Medicaid beneficiaries.

Other insurers, such as Humana, have recognized that addressing the social determinants of health helps improve care outcomes and lower costs.

As part of its six-year Bold Goal campaign, Humana recently announced it was collaborating with Signify Health and the Alamo Area Community Network in Texas to connect those in need with social services.


UnitedHealthcare’s parent company, UnitedHealth Group, has long invested in helping address social determinants of health, including providing more than 1 million referrals to important social services and contributing over $500 million to support affordable housing for people across the country. 

In addition, UnitedHealthcare previously collaborated with the American Medical Association to develop ICD-10 codes to more precisely diagnose social determinants of health.

Research from the Robert Wood Johnson Foundation suggests that various social barriers impact up to 80% of a person’s health.

“UnitedHealthcare is in a unique position to help improve people’s health and well-being by addressing social determinants of health,” said Rebecca Madsen, chief consumer officer, UnitedHealthcare. “With COVID-19 highlighting the need to help close the gap between healthcare and access to services that contribute to well-being, UnitedHealthcare has incorporated social determinants of health into our advocacy service model, providing people with important support as they navigate the health system.”

Twitter: @SusanJMorse
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