Person-centered care is a framework that healthcare payers and providers use to ensure care plans address the full spectrum of health-related needs that members face, including medical, behavioral, and social determinants of health (SDOH). In contrast to other models of care, a person-centered approach to care recognizes that each member deserves a care plan that…
Value-based care, the care delivery and reimbursement reform movement that emphasizes outcomes over volume of services rendered, could not be successful without strong and meaningful patient engagement. Defined by the Centers for Medicare & Medicaid Services as programs that “reward health care providers with incentive payments for the quality of care they give to people with…
Dr Alex Ng discovered during his early medical career in a role as chief resident at the Middlemore hospital in New Zealand that he wanted to support those who are underprivileged. The hospital was a referral unit for tertiary and quaternary care for the South Pacific islands, which allowed him to witness the impact of…
HHS needs to expand the list of social determinants of health that public payers can cover and hold public payers accountable to covering preventive services that can help address social determinants of health, the Bipartisan Policy Center said in a report. “The U.S. can improve population health and health outcomes by integrating social services with the…
Z codes, which are ICD-10-CM codes used to identify non-medical factors that may affect a patient’s health status, are a useful way to track social determinants of health and capture standardized data for Medicare beneficiaries. However, they are underused, with Z codes reported from only 1.59 percent of beneficiaries in 2019, according to a new…
Healthcare only accounts for a small percentage of a person’s overall wellbeing and health, but external factors such as socioeconomic status and access to food are difficult to capture and leverage within the healthcare system. Machine learning models may help bridge that gap. Research from Regenstrief Institute and Indiana University Richard M. Fairbanks School of…
The concept of holistic, or whole person, care continues to gain traction as the best way to address the healthcare sector’s overall mission of improved health outcomes, lower costs and improved patient experiences. Understanding the role of social determinants of health (SDOH) has become a primary focus for providers, payers, consumers and government agencies because…
Applying data governance strategies can help healthcare facilities capture and use social determinants of health (SDOH) data, and a key part of that process is appropriate coding, according to an American Health Information Management Association (AHIMA) white paper. “When it comes to revenue cycle, I think what it comes down to is quality,” Julie A. Pursley, MSHI, RHIA,…
There is growing concern among many well-respected providers about the consequences of fewer preventive services over the past 1½ years as a result of the COVID-19 pandemic. As patients slowly start to resume care throughout 2021 and into 2022, experts predict we will see a spike in the number of severe or late-stage diagnoses that normally…
Social determinants of health contracting with community-based organizations remains a complex and challenging task for payers as the demand for answers grows more pressing. As the industry’s awareness of social determinants of health expands, so does the need for evidence-based solutions. Often, these solutions require health insurers and health systems to contract with community-based organizations…