• Keslie Crichton

How are you planning on using the expanded SDoH Z codes in your business?

New SDoH code assignments take effect on Oct.1, 2021

While many payers and some providers are accustomed to using community assistance programs and databases to assist their members, this data is rarely captured or easily shared amongst others that touch the member. Although social determinants of health have always been a barrier for many to receiving healthcare and living their best lives, it’s only recently that it's become a focus across government entities, providers, and payers. Fortunately, our healthcare system is proactively addressing the value of documenting and impacting SDoH barriers.


The BeneLynk team has worked for decades in government benefits programs and the managed care industry. We made it our mission to build the largest dual enrollment program as well as the first community assistance program. We weren’t trying to change the world, or even communities; we offered these programs because it was the right thing to do for your most vulnerable members.


Today we follow these same guiding principles and mission, but we now also have the ability to be better, to do better and to help more people facing barriers to living their healthiest lives. We saw a need for serious change, and with our decades of expertise in navigating government and community benefits, we formed an organization focused on cultivating deeper human connections to make a remarkable difference.


Along with many of our clients, The Gravity Project, and other organizations, BeneLynk has supported SDoH Z code expansion, the use of SDoH codes to support, where appropriate, differences in risk adjustment and HEDIS metrics. The Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) approved new SDoH code assignments to take effect on October 1, 2021, and BeneLynk is incorporating these additional codes into our member detail SDoH reports.


BeneLynk’s reporting allows health plans to see trends that allow you to explore actionable insights. Data can be segmented by state, by plan, by region or just about any other filter. Expanding the codes simply provides more data to better understand your member’s challenges and the ability to solve for these issues.


Due to value-based contracting increases, both payers and providers need to address SDoH challenges to ensure they are helping members while reducing future readmissions and avoiding unnecessary hospitals stays. Reimbursement guidelines for Medicare Advantage, Managed Medicaid and ACA should be easily understood and consistent so that payers and providers know what to include in their encounters, to be reimbursed for their additional assistance.


BeneLynk helps plans and providers to deliver SDoH evaluations telephonically or in person. By employing one dynamic conversation that flows organically to meet SDoH challenges, we build stronger human connections that are supported by innovative technology. We fully understand and document barriers, then surface solutions and provide the advocacy that changes lives and improves outcomes. BeneLynk applauds everyone that contributed to this initiative and those yet to come.

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