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…
Social determinants hold the potential improve care, reduce costs and enhance the lives of individuals, but so far the business and financial incentives haven’t existed for putting them to widespread use. With the transition to value-based care and population health programs, however, social determinants are on the verge of becoming more mainstream. But that will…
To drive down health care costs and improve outcomes for patients with chronic illnesses, New York’s Northwell Health hospital system is training health care workers who can better relate to—and help—people from underserved and largely minority communities. Less than a year old, Northwell’s program has trained nearly 30 people to become community health workers, a…
Social determinants of health are becoming increasingly mainstream. From health plans to health lawyers to Secretary Alex Azar, seemingly everyone in the healthcare realm now acknowledges that social determinants are a legitimate cause of poor health outcomes and health disparities and, more importantly, need to be addressed. Now a new series in the New England Journal…
Excerpt: “Social determinants of health is an abstract term, but for millions of Americans, it is a very tangible, frightening challenge: How can someone manage diabetes if they are constantly worrying about how they’re going to afford their meals each week? How can a mother with an asthmatic son really improve his health if it’s…
Greater use of the emergency room has been linked to homelessness, diabetes-related hospital admissions have been attributed to food insecurity, and social isolation has been identified as a risk factor for stroke and heart attack. These are just a few of the ways in which the social determinants of health (SDoH) contribute to health outcomes,…
Accountable care organizations (ACOs) often care for many patients with complex, chronic conditions that can lead to high expenditures and utilization of care. In the United States, 1% of the population accounts for 21% of healthcare expenditures and the costliest 5% account for more than half of all health spending, according to a report published…
Nearly 90% of U.S. physicians say at least some of their patients have a social condition that poses a serious impediment to their health whether it be unemployment, lack of education or drug addiction, a new nationwide survey of doctors shows. The biennial survey from the Physicians Foundation shows 88% of physicians have at least…
The transition to value-based care has expanded the definition of patient wellness to include both physical and social health. As patient care stretches into the community, the healthcare workforce begins to center on the community health worker. Community health workers “are frontline public health workers who have a close understanding of the community they serve,”…