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Innovative Strategies for Health Plans to Mitigate Social Risk

Innovative Strategies for Health Plans to Mitigate Social Risk

April Richardson, MD

Vice President,
Clinical Services,
BCBS of South Carolina

Dr. Richardson is an Adult, Child and Adolescent, and Forensic Psychiatrist and is the current Vice President of Clinical Services at BlueCross BlueShield of South Carolina and Chief Operating Officer of Companion Benefit Alternative at BCBS South Carolina. Dr. Richardson has been working at the plan for the past nine years and provides oversight for medical, maternity and behavioral health utilization management, case management, population health and claims-based specialty case management across our commercial and Medicaid business.  She also oversees the contracting and credentialing for the behavioral health network.

Prior to her work at BCBS, she worked in acute psychiatric care and private practice psychiatry in South Carolina. Dr. Richardson received her undergraduate degree from the University of Michigan and attended medical school at Michigan State University. Dr. Richardson then completed her training in Adult Psychiatry at the University of South Carolina/Palmetto Health Alliance. She completed additional training in Child and Adolescent Psychiatry and Forensic Psychiatry at the University of South Carolina/Palmetto Health

 

Trenor Williams, MD

CEO & Co-Founder,
Socially Determined

Dr. Williams is a family physician, entrepreneur, former health system executive and consulting leader and past founder and CEO of Clinovations which he sold to the Advisory Board Company (ABCO) in 2014.  In 2017, Dr. Williams co-founded Socially Determined in order to create an analytics platform that integrates the social determinants of health with clinical and claims data in order to quantify and visualize social risk and the specific impacts on health and healthcare outcomes.  Socially Determined creates holistic models of people, the communities they live in, and their interactions with the healthcare system. Through that process, the company creates a SDOH risk score, a FICO score for healthcare, which will help health systems and health plans more comprehensively understand their patients and how to support them.  With more than 20 years of healthcare experience, Dr. Williams’ unique perspective is formed at the intersection of healthcare and technology. He has an extensive understanding and knowledge in the implementation of healthcare technology, health plan market growth and SDOH strategy development for leading healthcare stakeholders here in the United States and around the world.  Before beginning his consulting career, Dr. Williams was the medical director of Family Practice at Mammoth Hospital in California. He also served as a Lieutenant Commander in the United States Naval Reserve. Dr. Williams completed his family practice residency at Kaiser Permanente in Los Angeles. He holds a Bachelor of Science in Biology from Virginia Polytechnic Institute, and received his Medical Doctorate from Marshall University.

Ellen Kelsay

President & CEO,
Business Group on Health

Ellen is president and CEO of Business Group on Health. She is a sought-after speaker and expert on health and well-being issues. Kelsay hosts the Business Group on Health podcast and has authored various industry publications including an article in Harvard Business Review on health equity, an op-ed in Modern Healthcare on value purchasing and an article in Pharmaceutical Executive on affordability and transparency for pharmacy transformation. She has been recognized by Modern Healthcare as one of the 100 Most Influential People in Healthcare. She has delivered Congressional testimony and is frequently cited in the press.

Business Group on Health is the largest non-profit organization devoted exclusively to representing employers’ perspectives on critical health, well-being and workforce strategy issues. The Business Group keeps its membership on the leading edge of innovation, thinking and action to address the delivery, financing, affordability and experience with the health care system. Leveraging its network of members and industry thought leaders, the Business Group drives change by sharing best practices, shaping health care policy and crafting innovative solutions to improve employee health and well-being and optimize business performance. Business Group members, many of whom have operations globally, include most Fortune 100 companies and over 450 companies in total who provide health coverage and well-being solutions for more than 60 million employees, retirees and their families in over 200 countries.

 

Shantanu Agrawal, MD, MPhil

Chief Health Officer, Elevance Health

Shantanu oversees the enterprise whole health strategy, including medical policy and clinical quality, as well as our industry-leading work to address health-related social needs and health equity. Passionate about improving health outcomes and reducing disparities, Shantanu draws on his clinical and business expertise to push for a more equitable health space for the people Elevance Health serves. Accordingly, he also leads Elevance Health’s community health strategy and the Elevance Health Foundation. Outside of Elevance Health, Shantanu serves on numerous boards and committees that deepen his commitment to advancing health.

 

Innovative Strategies for Health Plans to Mitigate Social Risk

Gaps exist in understanding someone’s overall health, inhibiting the ability of commercial health insurers to meet members where they are, provide great care, and engage them in a healthcare journey.

To truly understand a member’s health, gaining insight into all barriers to care is essential. This includes the member’s social risks such as food insecurities, housing instabilities, financial strain, health literacy challenges, and lack of transportation. By addressing these comprehensive aspects of a member’s life, health plans can provide a more holistic and effective healthcare journey.

Gathering the right analytics and understanding members’ social risk allow plans to determine the areas most impacting business results. This information helps plans make efficient decisions and create effective measures and outcomes.

Our expert panel explores the value of quantifying the impact of the social risks and shares actions health plans can take to improve health outcomes, reduce health disparities, decrease costs and track measurable results.

April Richardson, MD

Vice President,
Clinical Services,
BCBS of South Carolina

Trenor Williams, MD

CEO & Co-Founder,
Socially Determined

Ellen Kelsay

President & CEO,
Business Group on Health

Shantanu Agrawal, MD, MPhil

Chief Health Officer, Elevance Health

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