Humana Launches Medicare Advantage SDoH Program

Finding new ways to address the social determinants of health has become somewhat of a calling card for Humana Inc. (NYSE: HUM).

This time around, the company announced a new program that reimburses health systems for referring Medicare Advantage members to social services. 

Louisville, Kentucky-based Humana is both a payer and in-home care provider. Its home-based care business lines include Humana At Home and Kindred at Home, the largest home health provider in the U.S., according to LexisNexis.


Broadly, social determinants of health are socioeconomic and environmental factors that impact differences in health status. Humana’s program — the Social Determinants of Health Value-Based Program — specifically focuses on food insecurity, social isolation, loneliness and housing instability.

Over the years, a number of in-home companies have made addressing social determinants of health a priority. Companies such as HomeThrive, for example, have been active in quelling transportation challenges.

Humana’s program requires participating providers to screen Medicare Advantage members for social determinants of health, document the process and connect the members to relevant resources.


“This new model is part of an ongoing expansion of Humana’s value-based program portfolio, as we continue to align with clinicians to more holistically address patients’ health care needs,” Oraida Roman, VP of value-based strategies at Humana, said in a statement. “Humana is proud to collaborate with providers in proactively addressing impediments to well-being, instead of only treating people when they’re sick. We’re committed to addressing the critical challenges presented by nonmedical health risk factors.”

While a focus on social determinants of health has become more common, hospitals and physician practices aren’t widely screening for such factors.

Overall, only 24% of hospitals and 16% of physician practices screen for recommended social determinants of health, according to a JAMA study. Oftentimes, clinicians lack the resources to address these issues.

Programs like Humana’s could make a key difference in changing this.

The Social Determinants of Health Value-Based Program is far from the company’s first foray into the social determinants of health.

In January, the company’s philanthropic arm, the Humana Foundation, unveiled its plans to invest $1 million — as part of a larger effort to invest $7.6 million in eight communities — in two New Orleans organizations to address social determinants of health.

In 2015, Humana launched the Bold Goal initiative to address the social determinants of health and improve the health of the communities the company serves by 2020.

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