A strong business case exists for addressing the financial impacts of social determinants of health (SDoH) and new reimbursement models designed to emphasize health equity. Involving revenue cycle management (RCM) is necessary for any comprehensive SDoH/health equity strategy.
This is because health disparities contribute more than $93 billion in unnecessary medical care costs and more than $42 billion annually in lost productivity. Additional economic losses are a result of premature deaths. Further, according to the W.K. Kellogg Foundation, eliminating these inequities by 2050 may erase more than $150 billion in unnecessary medical care.
Reimbursement is also closely linked to quality because of the use of outcome measures by the Centers for Medicare and Medicaid Services (CMS) to determine a hospital’s overall quality, including:
- Safety of care
- Readmission rate
- Excess stay
- Patient experience
- Effectiveness of care