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Understanding the Gap in Health Plan Effectiveness with SDoH Data

Social drivers of health (SDoH) have emerged as critical factors influencing health outcomes, particularly among maternal populations. Recent research by Sage Growth Partners highlights a stark contrast between the significant collection of SDoH data by health plans and their ability to effectively utilize this information for action.

The Data Collection Paradox

According to the findings from a survey conducted among 50 health plan leaders, a substantial 60% reported that they collect SDoH screening data. However, a mere 7% deemed their organizations to be "very effective" in employing this data to drive meaningful interventions. This mismatch raises important questions about how health plans can evolve from mere information gatherers to proactive responders in the health landscape.

Data versus Action

Dan D'Orazio, CEO of Sage Growth Partners, points out that the pressing challenge does not lie in the accumulation of data. Instead, the issue is transforming this data into actionable strategies. He notes, "Health plans don’t have a data problem. They have an action problem." This statement underscores the lost potential that resides in databases, which, if actionable insights are not derived from them, achieve little to impact maternal health outcomes.

The Maternal Health Gap

The stakes regarding maternal health are high. Several significant gaps have been identified by health plan leaders that present barriers to optimal maternal care:

• - 66% report insufficient access to OB/GYNs in rural regions.
• - 62% highlight the lack of access to specialists in high-risk obstetrics and maternal-fetal medicine.
• - 56% acknowledge a shortfall in behavioral health services, especially for postpartum depression.
• - 46% cite issues regarding timely completion of initial prenatal visits within recommended time frames.
• - 38% face challenges with NICU capacity.

These statistics illustrate that while data is being collected, health plans must reconsider their strategies to make impactful use of the information at hand.

Moving from Data to Action

The report from Sage outlines a five-step path that health plans should consider to transition from information gathering to strategic action:
1. Screen Members: Identify broad social needs among health plan members.
2. Map Needs: Align those identified needs with risks specific to maternal health, postpartum care, and NICU services.
3. Connect Members: Facilitate connections between members and essential case management, benefits, and community resources.
4. Track Progress: Monitor which needs are effectively resolved and which continue to be unmet.
5. Act on Gaps: Utilize gathered data to direct investments and forge partnerships that address identified gaps in care.

This strategic approach positions health plans not merely as data collectors but as proactive engines of change capable of improving health outcomes within their communities, particularly among mothers and their children.

Long-Term Investments with Patience for Returns

Furthermore, the survey indicates a forward-looking perspective among the leaders surveyed. About 64% expressed comfort with an ROI (return on investment) timeline stretching up to three years for investments meant to tackle SDoH challenges. D'Orazio observed that this willingness to evaluate SDoH investments over extended periods presents an opportunity for health plans to make meaningful changes without the immediate pressure for returns, thus fostering a pathway to improved access and overall member experiences.

Conclusion: A Roadmap for Future Action

As part three of Sage Growth Partners’ research series on maternal and NICU care, this report sheds light on the critical need for health plans to transform SDoH data into actionable strategies. By addressing the barriers identified and implementing the recommended five-step path, health plans can enhance their support for maternal populations, thereby fostering healthier outcomes. The essential takeaway is that the wealth of data available presents an opportunity that only a proactive approach can unlock to reshape maternal health positively.

For further insights, the full report titled From SDoH Data to Maternal Health Action is available for download from Sage Growth Partners.