ORLANDO, Fla. — Helping improve patient outcomes by identifying and removing barriers to their care is just one reason AllianceRx Walgreens Prime and Highmark Inc. have joined forces to launch a social determinants of health (SDOH) pilot outreach program. The pilot will kick off with Highmark insurance members who have a multiple sclerosis (MS) diagnosis and use AllianceRx Walgreens Prime as their specialty pharmacy. The program will identify MS patients impacted by SDOH so referrals can be offered to social work, behavioral health, or other appropriate resources.
SDOH are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes. These conditions include financial resource strain, social connections, safety, transportation needs, health literacy, food insecurity, and housing stability.
“With SDOH factors impacting 80% of health outcomes, understanding a patient’s physical environment, social determinates and behavioral factors will help tailor a specific plan of care to each member who completes the SDOH survey,” says Rick Miller, vice president, clinical and professional services at AllianceRx Walgreens Prime. “The pilot is designed to understand the success rate of a specialty pharmacy in administering the SDOH survey as well as the ability for the member to have any SDOH-identified issues addressed.”
“The outreach conducted through this pilot program is the first step to help ensure members who are already facing health challenges have the support and resources they need to overcome barriers in other aspects of their lives which impact their health. By reducing or eliminating these barriers, people are free to be their best,” says Amy Shannon, director, health and wellbeing integration at Highmark.
How the pilot program works
To be included in the pilot, Highmark members with an MS diagnosis must be willing to participate in the brief, voluntary survey. SDOH-trained nurses from AllianceRx Walgreens Prime will contact eligible Highmark members by telephone and offer to administer the 13-question SDOH survey. Highmark will review the survey results to determine how the health insurer may assist members facing SDOH factors and affect change on any domains identified from the survey.
AllianceRx Walgreens Prime will contact Highmark members and assess each member, utilizing the SDOH tool developed for the pilot. Outreach phone calls to Highmark members began April 19. The SDOH pilot program for MS patients/members will continue for one year; future phases may include additional patient populations based on the success of this pilot.
“This pilot demonstrates the continual evolution of patient care and collaborative efforts between key stakeholders,” says Nebeyou Abebe, senior vice president of social determinants of health for Highmark. “Highmark recognizes that to understand and impact health, we must consider the physical, mental, and social health of our members. Understanding, identifying and addressing SDOH factors that MS patients experience is a further commitment to improving their treatment journey and overall outcomes.”
Miller says patient outreach is a core competency at AllianceRx Walgreens Prime. The pharmacy contacts each patient prior to the initiation of therapy and each refill to assess for clinical appropriateness as well as collect patient reported outcomes. “Expanding assessment capabilities to include SDOH factors is a natural progression in the role of a specialty pharmacy,” he says. “This pilot demonstrates how AllianceRx Walgreens Prime innovates and collaborates with healthcare partners such as Highmark – as both companies have the shared goal of improving the quality of life of the patients and members we are fortunate to serve.”
AllianceRx Walgreens Prime and Highmark will analyze the data from the pilot for success – with plans to expand to other disease states in the future.