UPMC Health Plan launches new data-backed SDOH initiative

UPMC Health Plan in Pittsburgh has announced it will launch a new social impact initiative that will use evidence-based research to better address social determinants of health.

UPMC Health Plan, which has been at the forefront of the SDOH movement for more than 10 years, is calling its new initiative UPMC Social Impact, and it will be led by the UPMC Center for High-Value Health Care. The Center translates data gathered from the UPMC payer-provider partnership in an effort to improve care.

“The goal of UPMC Social Impact is to help meet the health, socioeconomic and environmental needs of UPMC Health Plan members and the communities we serve,” says John Lovelace, president of government programs at UPMC Health Plan. “The initiative will create new social responsibility programs and expand upon our existing programs to positively impact the health and wellbeing of our members, employees and the neighborhoods where we live and work.”


UPMC Social Impact will expand upon UPMC Health Plan’s efforts already underway to meet the nutritional, housing, employment and transportation needs of underserved area residents and UPMC Health Plan members. It will improve coordination of healthcare for the mentally and physically disabled, as well as for LGBTQIA individuals, the health plan says. It will also coordinate programs across state, county and local programs, including early childhood initiatives, childcare and well childcare, and it will help prevent social isolation, especially for individuals with dementia.

UPMC Social Impact will also drive corporate social responsibility, including future business and investment opportunities within these areas, the health plan says.

UPMC recently has been coming at the SDOH effort from all angles. Last May, the UPMC Center for High-Value Health Care and the Wolff Center UPMC hosted a conference with the Patient-Centered Outcomes Research Institute that focused on ways stakeholders can accelerate patient-centered outcomes and comparative effectiveness research in a learning health system, like the kind needed to address SDOH. UPMC has been interested in targeting how payers, providers, researchers and other stakeholders can work together to overcome barriers to conducting patient-centered outcomes research and comparative effectiveness research.

James Schuster, MD, chief medical officer of the UPMC Insurance Services Division, says new research devoted to patient-centered outcomes and comparative effectiveness research will be the key to accelerating the transformation of healthcare.

Executives at UPMC Enterprises say when SDOH goes unaddressed, it can create barriers to effective treatment and can lead to poor health outcomes. UPMC Enterprises has determined that just recognizing there is a need isn’t enough—machine learning and analytics must be applied to develop intervention strategies that will have an impact, its executives contend.

UPMC announced last June that it is studying how SDOH affects Medicare and Pediatric Medicaid populations. Clinical data from these two groups will be analyzed with machine learning models to understand how they impact health outcomes.

“That hardest part is that this is a new space for hospital systems to tackle; providers and clinical teams have not had a way to access SDOH insights in a systematic way in the past,” says Minette Vaccariello, product manager at UPMC Enterprises in a June 27 blog. “There is very little tracking on SDOH intervention programs, specifically how addressing them can improve health outcomes, which makes tying this work back to ROI a challenge,” she says.