Valerie Cerra, chief of staff at GroundGame.Health, is a healthcare industry veteran leading with a new lens, grounded in social impact.
I’ve spent the past year in the same industry I spent the previous 16, but I barely recognized it. In October 2023, I started consulting for an organization described as a social impact company. The description was new to me, but I understood this meant it is grounded in a social mission and keeps many social care professionals busy on that mission.
A few months into my work with this organization, I had an epiphany. This social impact company was really a healthcare company. An entire sector of healthcare was operating, and I didn’t see it.
“Clinical factors are responsible for just 20 percent of individuals’ health outcomes; the remainder can be attributed to factors such as health-related social needs,” according to a McKinsey article. HRSNs directly impact individuals; these needs might include housing insecurity or lack of access to healthy food or transportation. Additionally, McKinsey said that 45% of consumers report experiencing at least one HRSN on a regular basis, and the majority of those have more than one unmet need.
As a long-term portfolio management professional, I translate this as a macro risk that needs to be controlled to ensure other investments and innovations have certain outcomes. How did I miss this for so long?
Social Care In Healthcare
I think of the social sector a little like an underrated sidekick who has been there quietly doing big things all along. Until recently, I noticed social care was often a rounding error on the profit and loss statement of big healthcare and mostly supported by government, donors and volunteers. Social care companies show returns in the number of lives helped and the dollars and hours spent in the community. Even as “HRSN” started showing up in the strategic vernacular of forward-looking health plans in the past few years, it has been mostly layered within initiatives like health equity and community giveback.
But thanks to some major advancements, social work is working its way up to the healthcare industry center stage. Like Buzz Lightyear, when he had his first big cinematic moment, and viewers realized Woody couldn’t be half the toy without him, this sidekick was ready for its moment.
To give you a real example, North Carolina ideated and implemented the Healthy Opportunities Pilots benefiting Medicaid recipients in certain counties. Participating health plans were required to provide evidence-based interventions that address social needs in four domains: food, housing, transportation and interpersonal violence/toxic stress. “Two years into the pilot, the state is spending about $85 less in medical costs per Healthy Opportunities Pilots (HOP) beneficiary per month,” according to the state’s Department of Health and Human Services. With more than 25,000 enrollees served as of Sept. 30, I estimate that this calculated to a net savings of more than $2 million per month.
Imagine what could happen if a program like this is optimized and scaled. What I also find interesting is the pilot data suggests to me that the biggest value isn’t in solving one social need but instead suggests that longer participation in the pilots may be associated with a greater cumulative reduction in healthcare costs.
From my view as a healthcare industry veteran, this is an enormous data point that will undoubtedly impact how social care is not just viewed but also funded. Anyone who has played a role in a healthcare cost-of-care portfolio will tell you this is a big return on investment. The modern me, the new member of the social care sector, also reflects on the success with a lens taught by my social care colleagues. Efforts to support HRSNs can transform and even save lives.
A Call To Action For Healthcare Leaders In 2025
I hope leaders in the healthcare industry and professionals deep in other mature sectors consider this a reminder to keep looking for opportunities to support health-related social needs. I’m declaring that 2025 will be the year healthcare gets social. With the advancement of Medicaid 1115 waiver programs—both in already approved states and those with pending applications—the push from the 2024 Centers for Medicare & Medicaid Services Physician Fee Schedule, and the inclusion of social needs metrics from HEDIS, we have state agencies, payers and providers all incentivized.
For those in healthcare, consider engaging with social care experts, and get to work. Identify colleagues who are working in this sector and get more tightly connected. Since drivers are unique to markets, listen closely for confirmation of relevant policy or investment results. Even better, self-educate on regulations in your market, including where support funding is initiated; this means someone has already identified a business case. Follow the National Committee for Quality Assurance’s work on the social needs quality measurement as well.
Don’t look past this type of work. Instead, find ways to promote it. Solving social needs is critical to healthcare. Now that you know, you can find ways to engage.
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