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The fact that social determinants need to be addressed as part of an effective care plan has been established and integrated as a standard in quality healthcare delivery. Now we need to move on to how we address them. While work in this area has been progressing over the past decade or so, the principal challenges remain – lack of data on both patients’ needs and the capabilities of community-based organizations (CBOs), lack of partnerships between providers and CBOs, and difficulty measuring the ROI of this work.
Collecting data on social needs is necessary but a clear and affordable tool to do so has yet to be determined, and though EMRs are beginning to look to develop such capabilities into their platforms, a standard is still a way off. However, CMS is already starting to require reporting on SDOH measures. In 2024, reporting on SDOH measures will become mandatory for hospitals and work to do the same for MSSP ACOs is already underway. Once the data is gathered, providers need to invest in building relationships with CBOs to meet the identified needs. Some provider groups are creating clinically integrated networks, similar to preferred provider networks with the potential for shared savings, but for CBOs, including utilizing shared referral/management platforms. Community Care Hubs are another promising model that is growing in popularity. But without adjusting payment models to account for social risk factors and/or investment in health-related social services, true progress will be difficult. New value-based payment models could offer the flexibility needed to make change here as well.
It is time to move beyond recognizing the need to address social determinants. We must start creating the innovation and change needed to effectively act on this. The building blocks are there – integrated provider networks, value-based payment models, and platforms to support shared data and proactive data analysis. The return on the work should be self-evident – better clinical outcomes and quality of life, more appropriate utilization of clinical care, integration of health and social care providers, and impactful use of resources.
Source Material: “Working with ACOs to Address Social Determinants of Health” by Robert Mechanic and Ashley Fitch and posted on January 10, 2023, by Health Affairs and accessible at https://www.healthaffairs.org/content/forefront/working-acos-address-social-determinants-health
