News

Pilot program dedicates PA 211 navigators to specifically support UPMC for You members

PITTSBURGH, PA (March 21 2023)—PA 211 and UPMC for You today announced the launch of a 12-month pilot program to connect UPMC for You members to resources to address social determinants of health (SDOH) needs through the United Way of Pennsylvania’s 211 statewide referral database. The partnership commits dedicated resources, including extensive member-level engagement, to specifically serve UPMC for You members.

Offering members access to community-based supports can help to mitigate SDOH needs, which are often predictors of an individual’s health outcomes and well-being. If unaddressed, SDOH needs can lead to disparities in care, poor health outcomes, and a significant economic burden on vulnerable populations.  

“UPMC for You recognizes that individual health can be significantly impacted by more than just the health care you receive,” said John Lovelace, President of Government Programs, UPMC Health Plan.  “Our partnership with the United Way’s PA 211 referral service reflects our ongoing, multipronged commitment to helping our members connect with the resources they need to help address health disparity-related challenges, such as access to housing, fresh food and meaningful job training.”

UPMC for You, a Medicaid physical health managed care plan that is part of a family of health insurance and benefits management products offered by UPMC Insurance Services Division, currently serves more than 723,000 eligible Pennsylvanians.  To help these members access additional social supports, UPMC for You has partnered with PA 211, a resource that assembles and directs federal, state, and local resources to low- to moderate-income individuals who are facing social determinants of health-related (SDOH) challenges. These barriers include childcare access and affordability, clothing needs, unemployment, financial strain, food insecurity, housing instability or homelessness, transportation, and utility service.

Under the pilot, UPMC for You’s Resource Navigation Hub connects its Medicaid members to PA 211’s dedicated team of navigators, who help individuals connect with community organizations that meet specific member needs. Navigators also follow up with members to confirm that their SDOH needs are addressed. UPMC for You’s partnership is unique in that it provides its members access to a dedicated PA 211 team and extensive member-level engagement and one-on-one service.

“We are excited about our partnership with UPMC for You and connecting their members to the most appropriate community-based resources available, said Kemi Ekunkoya, project manager with PA 211. “Optimizing the members’ experience and expanding health equity to improve their health is the number one priority for us.”

Project Overview 

As part of the Physical HealthChoices Program, DHS implemented a Value-Based Purchasing (VBP) program with the intent of improving physical health outcomes by addressing SDOH needs through partnerships between Medicaid managed care organizations (MCOs) and community-based organizations (CBOs).

About PA 211

PA 211 is a vital service leveraged by hundreds of thousands of Pennsylvanians annually. Every day, individuals contact PA 211 to access information and referrals to crisis and emergency counseling, disaster assistance, food, health care and insurance assistance, stable housing and utility payment assistance, employment services, veteran services, and childcare and family services. There are various ways to access PA 211’s services: on pa211.org via a public community resource database and web chat, via SMS, and over the phone. Our services are free and confidential and are available in 180 languages, 24/7/365. No matter the situation, the specialists at PA 211, listen, identify underlying problems, and connect people in need with resources and services in their community that improve their lives.

About UPMC Insurance Services

UPMC Insurance Services serves nearly 4.5 million members and is owned and operated by UPMC, a world-renowned health care provider and insurer in Pittsburgh, Pennsylvania. UPMC Insurance Services provides commercial products through UPMC Health Plan for both groups and individuals. Its commercial products also include workers’ compensation and employee assistance from nationally known Workpartners^®. Government products include Medicare Advantage plans (UPMC for Life); special needs plans for those who are eligible for Medicare and Medical Assistance (UPMC for Life Complete Care and UPMC Community HealthChoices); a Medical Assistance plan (UPMC for You); and Children’s Health Insurance Program plans (UPMC for Kids). Community Care Behavioral Health Organization—one of the nation’s largest nonprofit managed care behavioral health organizations—is also part of UPMC Insurance Services. Community Care offers a full range of services to commercial and Medical Assistance members. For more information, visit upmchealthplan.com.