Healthcare organizations recognize the value of SDOH data but simply have no idea where to start. They understand that SDOH factors can improve health outcomes and minimize medical costs, but they often do not fully understand what SDOH data to use to maximize the accuracy of predictive analytics or how to integrate the data into…
On August 11, 2020, the Centers for Medicare & Medicaid Services (CMS) Innovation Center announced the new Community Health Access and Rural Transformation (CHART) Model as part of the President’s recent executive order. The Model is an incredible accomplishment for patients and healthcare providers in rural areas that face social determinants of health (SDOH) challenges,…
Humana is bringing its value-based care know-how together with its aptitude for tackling social determinants among its Medicare Advantage (MA) members. The insurance giant announced it’s launching a new value-based care model to support providers in identifying and addressing several social concerns. The program will cover “enhanced” care coordination for patient screenings, documentation of assessment findings and linking patients to resources….
Despite agreement that the social determinants of health (SDOH) can impact accountable care organization (ACO) success, many see challenges in integrating interventions into practice, according to a new study published in Health Affairs obtained ahead of print by journalists. Specifically, ACOs face challenges in collecting data about patients experiencing key SDOH, creating meaningful community health partnerships, and…
Despite interest in addressing social determinants of health to improve patient outcomes, little progress has been made in integrating social services with medical care. We aimed to understand how health care providers with strong motivation (for example, operating under new payment models) and commitment (for example, early adopters) fared at addressing patients’ social needs. We…
Health is foundational for personal and community well-being for all people in America. Yet, the nation struggles to achieve health compared to our international peers and now, compared to even to prior United States health statistics. Though measures show that quality of care has improved in the past few years, evidence indicates that population health outcomes…
A growing number of physicians are not only asking their patients, “what’s wrong,” but “what’s happening?” This new awareness of the impact of life outside the exam room in determining health care status is fostered by the growing number of studies and discussion around social determinants of health (SDOH). Social determinants of health are the conditions…
Screening for social determinants of health (SDOH) is increasingly done in primary and specialty care settings. Payers and health care organizations have recognized the importance of these determinants not just to clinical outcomes but also to cost and use of services. Toward that end, both clinical and financial cases have been made for an expanded focus on SDOH for many, if not all,…
Starting in 2020, Medicare Advantage plans will be allowed to offer supplemental, “non-primarily health-related” benefits to help certain eligible chronically ill patients with unmet social needs. Put simply, this represents a large source of reimbursement for social determinants of health (SDOH) solutions in the high-growth MA market. While this represents a real opportunity for SDOH…
People with complex care needs account for nearly one-fifth of all health care spending, even though they comprise only 1 percent of patients. These are individuals with multiple chronic conditions or functional limitations; people whose conditions carry significant nonmedical needs; and frail older adults. Their mental health, physical health, and social needs require coordination across numerous…