The document summarizes the Blue Cross Blue Shield of Massachusetts Foundation's investments in social determinants of health. It discusses how social and environmental factors account for 60% of health outcomes but less is spent on social services than medical care. The Foundation focuses on housing, nutrition, and policy/advocacy grants. It aims to demonstrate connections between social services and health outcomes, identify metrics to measure cross-sector success, and convene stakeholders through conferences.

1. Grantmaking and Research
Investments in
Social Determinants of Health
Health Experience Design Conference
April 3, 2019
Jennifer Lee, Senior Program Officer

2. 2Blue Cross Blue Shield of Massachusetts Foundation
Overview of SDOH

3. 3Blue Cross Blue Shield of Massachusetts Foundation
World Health Organization’s Definition
The social determinants of health are the conditions in
which people are born, grow, live, work and age.
These circumstances are shaped by the distribution of
money, power and resources at global, national and
local levels. The social determinants of health are
mostly responsible for health inequities - the unfair
and avoidable differences in health status seen within
and between populations.

4. 4Blue Cross Blue Shield of Massachusetts Foundation
Equality vs. Equity
Source: http://interactioninstitute.org/illustrating-equality-vs-equity/

5. 5Blue Cross Blue Shield of Massachusetts Foundation
SDOH Levers for Change
(Upstream vs. Downstream)
• Policies at the state and federal level, including legislative and regulatory
changes to create healthy and health-promoting environments (smoke
free and tobacco pricing; active living/transportation; school nutrition and
physical education requirements; transfat bans; universal pre-K; Earned
Income Tax Credit and earned sick time; paid family leave; fair hiring
protections)
• Pilot (develop and test innovative care models for implementation in
health care delivery systems; measure ROI)
• Payment for non-medical services (LTSS, care coordination, housing
stabilization, nutrition support, asthma home visiting)
• Programs that focus on addressing disproportionate impact of SDOH
Social, environmental, and behavioral factors account for
60 percent of health outcomes, yet we continue to spend
more on medical care than social services.1
1
McGinnis et al., 2002

6. 6Blue Cross Blue Shield of Massachusetts Foundation
BCBSMA Foundation’s
Investments

7. 7Blue Cross Blue Shield of Massachusetts Foundation
2018 – 2020 Focus Areas

8. 8Blue Cross Blue Shield of Massachusetts Foundation
• The mission of the BCBSMA Foundation is to expand access
to health care for vulnerable and low-income people in the
Commonwealth.
Our mission is to expand access to health care for low-
income and vulnerable people in the Commonwealth
Policy/Advocacy
Agenda
Community
Partnership Agenda
SDOH & The Foundation
Why: SDOH disproportionately impact low-income and vulnerable
populations: health status, access to care, and affordability
What: Through research, grants, and convenings, we are working with leading
academics, advocates, and practitioners to examine the impact that spending on
social services can have on health outcomes, with a focus on promoting healthier
communities primarily through improved access to supportive housing (including
with the intersection with trauma/violence) and nutrition.

9. 9Blue Cross Blue Shield of Massachusetts Foundation
Foundation’s Investments:
Policy & Research

10. 10Blue Cross Blue Shield of Massachusetts Foundation
Policy & Research: Making the Case

11. 11Blue Cross Blue Shield of Massachusetts Foundation
Policy & Research:
Providing Resources & Tools
HOUSING Vital Sign™

12. 12Blue Cross Blue Shield of Massachusetts Foundation
Foundation’s Investments:
Grantmaking

13. 13Blue Cross Blue Shield of Massachusetts Foundation
2016-18 Social Equity & Health:
Evaluation Grants
• Two years of support to housing organizations to demonstrate the impact of
their supportive services on the health of their clients
• Each grantee focuses on a distinct population (elders, the chronically
homeless, low-income families) and delivers services in varied settings across
the Commonwealth
• Goal of analyses: identify greater synergies between the health care and
social services fields, with an eye toward supporting an advocacy and policy
agenda focused on payment options for social services
• Analyses are expected in late 2018/early 2019

14. 14Blue Cross Blue Shield of Massachusetts Foundation
2017-18: Evaluation & Collaboration Investments
Discretionary grants that address social determinants of health
and improved health outcomes by supporting statewide
coalitions and improved partnerships.
• Health Starts at Home – co-funded with The Boston Foundation
• Advocacy and Policy (Massachusetts Public Health Association’s Alliance
for Community Health Integration and Citizens’ Housing and Planning
Association)
• “Making the Case” (Community Servings and The Community Builders)
• Training and Capacity Building (Public Health Institute of Western
Massachusetts and Massachusetts Association of Community Development
Corporations)

15. 15Blue Cross Blue Shield of Massachusetts Foundation
2018-2021: Going Beyond Health Care
• Funding to support capacity and infrastructure of
interdisciplinary teams to coordinate in addressing non-
clinical and clinical needs for low-income and vulnerable
populations

16. 16Blue Cross Blue Shield of Massachusetts Foundation
Our Vision: Going Beyond Health Care

17. 17Blue Cross Blue Shield of Massachusetts Foundation
A Better Way to Measure
• Foundation’s consultant will work with grantees to identify and
develop a common set of non-health and health metrics that
can be:
• Used as core measures for the grantees in reporting, and
• Potentially serve as a universally adopted set of metrics beyond this grant, to measure the
success of interventions that span social services and health care
• Shared with state level agencies and payers for consideration
• Enhanced learning provided by Foundation to grantees to develop
knowledge between and among sectors

18. 18Blue Cross Blue Shield of Massachusetts Foundation
Convening the Community

19. 19Blue Cross Blue Shield of Massachusetts Foundation
June 2017 – Partnerships for Health: Bridging Community-Based Organizations
and Health Care

20. 20Blue Cross Blue Shield of Massachusetts Foundation
HOSPITALS AND HOUSING INVESTMENTS:
NATIONAL AND MASSACHUSETTS-BASED
APPROACHES
December 7, 2017
#hospitalsandhousing
@BCBSMAFdn @bostonfdn @CHAPAdotorg @masscdcs

21. 21Blue Cross Blue Shield of Massachusetts Foundation
NEW MODELS FOR
SOCIAL SERVICE INVESTMENT:
CONSIDERATIONS FOR
MASSACHUSETTS PARTNERSHIPS
October 10, 2018

22. 22Blue Cross Blue Shield of Massachusetts Foundation
THANK YOU!
Jennifer Lee, Senior Program Officer
Jennifer.Lee@bcbsma.com
(617) 246-3509
www.bluecrossmafoundation.org