Social Care Market Map: Solving for social determinants of health
This is part of Elion’s weekly market map series where we break down critical vendor categories and the key players in them. For more, become a member and sign up for our email here.
Only 1.6% of Medicaid patient records from 2020 and 2021 included a Z-code—the category of ICD-10 codes used to indicate social determinants of health (SDOH)—and only 1% of commercially insured patient records included one.
While SDOH are often a focus for public health entities, a lack of SDOH data collection and reporting can pose a major challenge for any provider organization aiming to offer patient-centered care, and especially health systems that take on risk through VBC arrangements. According to the CDC, “SDOH have been shown to have a greater influence on health than either genetic factors or access to healthcare services.”
CMS states the primary barriers to improved coding of SDOH are the absence of a standardized EHR screening tool, and lack of knowledge in providers and coding professionals. As of 2024, HCPCS code G0136 was introduced to provide reimbursement for a 5-15 minute SDOH assessment, and vendors in the social care category are stepping in to support SDOH efforts with technology.
What Do Social Care Products Do?
Vendors in our social care category include tech products that identify, track, and help mitigate barriers to care, including food scarcity, financial hardship, lack of transportation, and other system issues. Functionality across these products includes:
SDOH screening tools integrated within existing provider or coding workflows
Identification of and referral to appropriate services
Tracking effectiveness of social care interventions
Delivery of services, including food, transportation, and other in-home services
Differentiating Social Care Vendors
Vendors can essentially be differentiated based on whether they are focused more on the tech side of this equation—identifying patient needs and tracking outcomes—or on service delivery.
Within the tech side of this category:
ActivateCare, Alvee.io, FindHelp, Unite Us, CareMessage, and WellSky allow organizations to screen, create their own closed-loop referral networks, coordinate referrals, and provide outcome analytics. Some also include provider education.
Focusing more specifically on screening, Phreesia collects SDOH data on patient intake and allows providers to tailor patient engagement content based on the needs identified.
Socially Determined and ZeOmega leverage data from various sources, including clinical and outside claims data, to identify at-risk patients and measure the effectiveness of interventions across a population.
Auxa Health uses proprietary algorithms for matching patients to eligible benefits and provides patient engagement tools for enrolling patients.
Homethrive and AccessMeCare offer similar care coordination services designed primarily for family caregivers, but can also be used by providers, health plans, and employers.
Service delivery vendors generally differentiate according to the SDOH category they support. For example:
Ride Health and Roundtrip offer transportation coordination and Uber Health provides actual transportation services and prescription and grocery delivery. Similarly, Instacart Health delivers diagnosis-specific food to food-insecure patients.
DocGo provides mobile medical care, medical transportation, and remote patient monitoring.
Papa offers companionship and support services for members of Medicare Advantage, Medicaid, and Special Needs Health Plans.
The Future of Social Care Solutions
Given the scale needed to build a service delivery network, it’s no surprise that we’re seeing more vendors on the screening, coordination, and analytics side of this equation. The entrance of mainstream tech solutions like Uber and Instacart into healthcare service delivery could, however, be an interesting glimpse into the future of social care. We look forward to seeing whether healthcare tech solutions continue to partner with these service-delivery experts to expand existing solutions and offer more comprehensive end-to-end platforms.