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Despite New Programs, Major Payers Still Spending Less Than 1% on Income on Social Determinants of Health

Top six payers likely spent less than 1% of their 2021 income on social determinants of health initiatives

November 21, 2022As the healthcare industry shifts more spending toward social determinants of health (SDOH) in recent years, an article in the Journal of General Internal Medicine takes a deeper look into trends in social spending by private health insurers. 

From 2017 to 2019, US health systems invested over $2.5 billion in programs that target social determinants of health. However, David E. Velasquez BS, Swathi Srinivasan BA, and Jose F. Figueroa MD, MPH, wanted to see how private insurers, which comprised 28% of total health expenditures in the country in 2020, are actually investing in SDOH. 

To do this, the researchers examined social spending across the top 20 US health insurers by market share. They broke social spending into six categories that loosely overlap with social determinants of health. These categories included education, employment, food security, housing, social and community context, and transportation. They also created a seventh category, general SDOH, for social spending without a clear category. 

The results were certainly interesting. Between 2017 and 2021, total identifiable social spending for the top 20 private health insurers was approximately $1.87 billion. The top 6 insurers by market share, made up 72% of total social spending. However, while this seems positive, as a percent of total income in 2021, that $1.87 billion accounts for just 0.67%. 

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