SOCIAL RISK FACTORS AFFECTING OUTCOMES
Health disparities and our members
Each person's life experiences have a lot to do with their health journey. Social risk factors can affect anyone and lead to health disparities, or unfair and avoidable differences in health status. These factors can also correlate with racial and ethnic identities because of the historic inequities these groups have faced.
Obstacles like these can be measured and studied. And we're using that information to help equip people to make progress toward their own goals for better health. We've identified the social risk factors below as being correlated with health disparities between racial and ethnic groups.
Education
Hispanic members are 2x more likely to have less than a high school education when compared to non-Hispanic members.
Language
Half of Hispanic members and 30% of Asian members experience a language barrier when seeking care.
Safety
Black members are more likely to live in areas with a higher rate of violent crime, compared to White members.
Debt Burden
Black members are 6x more likely to suffer from debt compared to White members.
Behavioral Health Care Shortage
White and indigenous members are more likely to live in an area where there is a shortage of behavioral health professionals.
What we know
Using data to advance health equity
Social drivers of health are obstacles that can lead to health disparities, or unfair and avoidable differences in health status. These barriers can be measured and studied. We've compiled decades of data to create our proprietary social risk index, and we use it to identify the social barriers our members face by targeting our members' specific needs. We then equip our care teams with the training, tools, and resources to effectively provide the necessary services and supports.
What the Numbers Show
what we do
Using data to help improve health outcomes
Our data science team has collected extensive data and information from digital tools, as well as directly from our members, to create comprehensive predictive modeling of health disparities and the potential needs of our members and communities.
Understanding Member Experience
We prioritize the member experience by weighting social risk factors that have been directly identified by the member with surveys, phone calls and claims.
Through directly collected member data, we’ve analyzed over 200 different surveys and assessments, connected over 300,000 members to acknowledged social risk factors and received over 600,000 responses identifying these risks.
Using Location-Based Assessment
Our location-based assessment allows us to go much deeper than traditional boundaries of counties, cities and census tracts to identify concentrations of members with similar barriers to care and enable community-level response.
This precision allows us to identify similar needs across different communities and look at user data and trends to measure changes over time and potentially predict future needs.
We use drivetime access resources to identify and measure our members’ access to care based on drive times to in-network primary care and behavioral health providers, as well as measuring food access to fresh food stores.
Better Health Outcomes
We use data science to quantify the relationship between a member's social drivers of health and their health outcomes. Our care managers use this to prioritize their response by addressing the most critical member-level barriers to care.
What It Means
Ways we're supporting our members
Using our extensive data, we take action to provide resources and services to our members. These are just a few ways we’ve supported our members.
Quality Partnerships
More than 80% of primary care providers in our networks have value-based contracts. That means we pay them based on health outcomes, like making sure their patients get the right preventive and maintenance care.
BlueCross Healthy Places
The BlueCross BlueShield of Tennessee Foundation is building BlueCross Healthy Places across Tennessee to provide our neighbors with opportunities for healthy activity and to help strengthen bonds within our communities. All spaces are free and open to the public. Our foundation invests at least $7.5 million each year to create spaces for our neighbors to come together that include playgrounds, fitness equipment, gathering places and other features for visitors of all ages and abilities to enjoy.
Food Insecurity Support
To help those facing food insecurity, we’ve worked with non-profit organizations and groups to help provide fresh, healthy food sources directly in their communities. We’ve supported community refrigerators, community gardens, food pantries and food banks in different regions across the state, as well as hosted healthy eating on a budget courses to pair together food and diabetic nutrition education.
Transportation Services
We provide free, non-emergency transportation services to doctors or pharmacies up to 90 miles away for BlueCare Tennessee members.
Care Management
Our data sources and findings allow us to prioritize our members with the greatest risks and support them through our care management services.
How we're advancing health equity
We use our social risk index to help address health disparities and connect our members to resources to improve their health outcomes.
Social Risk Factors
How we identify health disparities
When we use the social risk index to measure how many barriers to care a member has, these factors often — but don’t always — correlate with racial and ethnic identities because of the historic injustices these groups have faced.
The index assists us in understanding each person’s relative risk level and find ways to help improve their health, sometimes with the aid of community partners and resources.
Economic Strain
Economic strain, along with healthcare access, has the strongest impact on our members' health outcomes. Economic strain factors include....
- Food insecurity: Possibly lacking regular or reliable food supply or likely to have a malnutrition diagnosis
- Housing: Experiencing homelessness or uncertainty about their living situation
- Financial strain: Having trouble affording necessities
- Debt burden: Likely to be in the lowest credit score segment
- Income: Earning less than the Federal Poverty Level
- Employment: Being unemployed or being employed in a service industry segment
- Medical cost burden: Facing difficulty affording medical costs
Education
Education issues have a strong impact on the health outcomes of our members. We can better serve our members by understanding potential barriers to care based on education level, literacy and language barriers. Health literacy also has an impact when members have trouble understanding health problems and information.
- Language: Not speaking English or having another type of language barrier
- Literacy: Having a low reading level
- Education: Having less than a high school education
- Health literacy: Having trouble understanding health problems and information
Healthcare Access
Healthcare access, along with economic strain, has the strongest impact on our members' health outcomes. Members can lack not only access to quality healthcare, but they could also live in an area without close proximity to, or with a shortage of, primary care providers and behavioral health care professionals. Lacking convenient transportation or needing transportation assistance also limits healthcare accessibility.
- Transportation: Lacking convenient transportation or needing transportation assistance
- Primary care access: Not having convenient access to primary care providers
- Behavioral health access: Not having convenient access to behavioral care providers
Safety
Safety-related drivers of health have a moderate impact on the health outcomes of our members. The safety category includes home safety, environmental safety and crime safety. Our members’ circumstances for safety include concern for their physical safety or living in an area with a high rate of violent crime.
- Home safety: Safety concerns in their home such as lack of heat or air conditioning, fall or trip hazards, faulty electrical wiring, or lead paint
- Crime safety: Living in a situation with a potential for violent crimes
- Environmental safety: Poor water, air, or soil quality due to local environmental factors
Social Issues
Social issues have a strong impact on the health outcomes of our members. Facing the possibility of discrimination because of race or ethnicity, or because of an intellectual or physical disability, impacts member healthcare. Members also face a lack of social support when living alone or without community connections.
- Racial discrimination: Facing the possibility of discrimination because of race or ethnicity.
- Disability discrimination: Facing the possibility of discrimination because of an intellectual or physical disability.
- Social support: Living alone or without community connections.
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