Initiative to provide funds to help patients with high levels of social needs

This is part of an ongoing series on health and health care disparities in Michigan and how Blue Cross Blue Shield of Michigan and its participating health care providers are working to address them.

The Physician Group Incentive Program team rolled out its new Social Risk Adjustment Initiative at the June PGIP meeting.

The initiative will support physician organizations caring for patients with high levels of social needs affecting their overall health. It will use the Area Deprivation Index to identify members who are at the highest risk for poor health outcomes. The ADI ranks areas from 1 to 10, with 10 representing the most disadvantaged areas.

About ADI

The ADI is based on a measure created by the Health Resources & Services Administration* more than three decades ago, and has since been refined, adapted and validated by a team at the University of Wisconsin-Madison.

The map below from the university’s Neighborhood Atlas^® website* shows the ADI scores for Michigan. Red indicates the most disadvantaged areas. The scores measure an area’s degree of social risk to residents down to the neighborhood block level, since social needs can vary greatly from block to block.

“Many studies show that patients experience a gradual worsening of various outcomes as the ADI level where they live increases,” said Dr. Marti Walsh, senior medical director and associate chief medical officer for Blue Cross. “Patients in higher ADI areas are shown to have worse health outcomes. Our goal is to provide some funding to help address these needs and improve outcomes.”

For purposes of this initiative, each physician organization will be evaluated for members who have an ADI of 8 or above. POs will receive funding based on the number of members they have in this higher ADI range. The funding is to be used to address the specific needs of their patient population, including transportation and food instability.

Participation information

To participate in this initiative for Year 1, POs must opt in by Aug. 31. 2023. POs will receive communications regarding the ADI scores of their attributed population and how this relates to their funding opportunity this summer. At that time, they’ll also receive an opt-in form, which should be completed and sent to POPrograms@bcbsm.com.

In 2024, we’ll ask them to complete a brief survey to collect status updates on the use of the funding. They’ll also begin participating in best practice sharing sessions.

Additional information will be available on Value Partnerships’ PO collaboration website.

*Blue Cross Blue Shield of Michigan doesn’t own or control this website.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.