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Numerous studies have shown that the failure to address individuals’ housing, food, transportation, and other health-related social needs (HRSNs) can result in poorer health outcomes and increased health care costs. Elizabeth Bradley and colleagues have published several empirical research studies and a book illustrating that the underinvestment in social services relative to health care, at least in part, explains why the United States has worse health outcomes compared to other developed countries. In the absence of broader social welfare programs, the burden of trying to address HRSNs often falls on health care stakeholders, especially providers and payers.
Given the benefits of addressing HRSNs that accrue to both individual as well as community health, we have come to expect some allocation of health care resources toward funding interventions designed to address social needs. This allocation can take the form of traditional charitable contributions toward community-based organizations and social programs. Value-based care (VBC) is increasingly being discussed as another way of aligning incentives to achieve this goal. Unlike traditional fee-for-service, VBC payment models are not limited to “billable services”—hence, VBC programs may offer more sustainable funding and quality measurement to pay for evidence-based non-medical interventions for transportation, nutrition, shelter, and other needs that decrease total cost of care.