Ciox Health Introduces Social Determinant Insights to Expand Data Utilities Suite

Ciox Health, a Datavant company, announced the addition of Social Determinant Insights to the recently announced Ciox Data Utilities. Ciox Data Utilities is a suite of solutions designed to add value to digital clinical chart retrievals. The clinical data supplementation suite is offered either stand-alone or as a bundle with Ciox Digital Direct, the leading solution for automated EMR chart extraction. Ciox Data Utilities comprises multiple offerings including Social Determinant Insights along with previously announced Structured Data Delivery & Data Harmonization. While Structured Data Delivery and Data Harmonization provide clinical chart level data in normalized and aggregated formats for easy ingestion into enterprise applications, Social Determinant Insights goes beyond the chart and augments member profiles with their individual socioeconomic conditions.

CMS recently issued guidance to state Medicaid directors to encourage the incorporation of value-based strategies across their healthcare systems allowing states to provide Medicaid beneficiaries with efficient, high quality care, while lowering cost and improving health outcomes. The guidance also noted that the adoption of value-based care arrangements could provide better opportunities for states to address social determinants of health (SDOH) as well as disparities across the health care system. The guidance recognizes that Medicaid and CHIP beneficiaries face challenges related to SDOH, including but not limited to access to nutritious food, affordable and accessible housing, quality education, and opportunities for meaningful employment. In its 2023 Advance Notice, CMS also solicited input on how enhancements might be made to incorporate social determinants of health into the CMS-HCC risk adjustment model.

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Ciox Social Determinant Insights appends health plan member’s data, with over 400 socioeconomic attributes ranging from financial security to transportation availability and demographic information including phone number, address, email address, and a deceased indicator. It also offers three Risk Scores for 1) Medication Adherence Risk 2) Total Utilization Risk Score, and 3) Member Engagement Risk Score. The output results in a breadth and depth of socioeconomic risk stratification that enables health plans to understand how and where to direct their health services resources to achieve better member health. By clearly identifying high, medium and low risk populations, plans can proactively target specific groups most likely to benefit from timely interventions and move them toward lower risk thus preventing adverse health outcomes and reducing plan utilization. In addition, Social Determinant Insights augments health plan member contact information with accurate phone, email, and address data to improve member engagement success rates.

Health plans can use Ciox Social Determinants Insights to assess new member enrollment and understand potential risks related to medication adherence, care motivation and more. Ciox Social Determinant Insights provides APIs that can be plugged into member registration workflows and touchpoints to access their socioeconomic data in near real time. This enables timely outreach from the plan to address these risks even before receiving claims data for the member at which point interventions may be less effective retroactively.

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“In today’s digital environment, it is critical that every health care decision is powered by data. However, much of the information necessary is siloed and not easily available to the provider or the health plan,” said Andy Kumar, VP of Product at Ciox Health. “Ciox Data Utilities unlocks clinical data from charts, and the new Social Determinants Insights funnels valuable non-clinical data into the mix, so health plans can ensure members are adequately cared for and their risk appropriately measured.”

“Social Determinants of Health have a major impact on quality-of-life outcomes, so adding this data to the clinical data is an important step that empowers Payers and Providers to address health inequities,” said Nick Giannasi PhD, Chief Product Officer at Ciox Health.

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