The issue of the high cost of healthcare in the United States is nothing new. As someone who works in the healthcare industry, you already know that. Our country’s spending in this area is approximately $3.3 trillion. That’s almost double per person compared to other developed nations.
Even so, the U.S. has a lower life expectancy and worse health outcomes than any other high-income nation. Why is that? Part of the problem is that some Americans don’t have access to healthcare. To address this issue, more healthcare providers and organizations, including the federal government, are developing initiatives centered around social determinants of health (SDOH).
Some Facts About SDOH
Most of you are familiar with SDOH. For those of you who don’t know much about it, the World Health Organization, defines it as “the conditions in which people are born, grow, live, work and age; these circumstances are shaped by the distribution of money, power and resources at global, national and local levels.” HIMSS lists the five factors that determine the health of a population as biologic, behavioral, social, physical and access to health services.
Here's a list of examples of SDOH, courtesy of the U.S. Department of Health and Human Services’ Health People 2020 initiative:
- Availability of resources to meet daily needs (e.g., safe housing and local food markets)
- Access to educational, economic and job opportunities
- Access to healthcare services
- Quality of education and job training
- Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities
- Transportation options
- Public safety
- Social support
- Social norms and attitudes (e.g. discrimination, racism and distrust of government)
- Exposure to crime, violence and social disorder (e.g. presence of trash and lack of cooperation in a community)
- Socioeconomic conditions (e.g. concentrated poverty and the stressful conditions that accompany it)
- Residential segregation
- Access to mass media and emerging technologies (e.g. cell phones, the Internet and social media)
Barriers to Care
Unfortunately, adults in the U.S. are the most likely to report financial barriers to healthcare, and those in rural areas are more likely to have difficulty accessing specialty care. However, focusing on SDOH is essential for improving health and reducing health disparities for these people. So, does this mean providers are tackling the issue head-on? Not necessarily.
A study published by JAMA just last month found that not many hospitals and physician practices screen their patients for the five primary areas included in SDOH. According to the study, only 24 percent of hospitals and 16 percent of physician practices reported screening in the following: food insecurity, housing instability, utility needs, transportation needs and interpersonal violence.
The JAMA study notes that the providers most involved in SDOH screening are those participating in bundled payments and primary care improvement models. Also in this group are federally-qualified health centers, academic medical centers and Medicaid ACOs.
Payers are starting to realize the importance of gathering data on SDOH. More than 80 percent of payers report integrating SDOH into their member programs. Many are even investing additional staff and other resources around it. A total of 19 states in 2017 required Medicaid managed care plans to either conduct screening for, or provide referrals to, address social needs.
Physician practices are busy places. Doctors are trying to provide the highest quality care to patients while complying with multiple rules and regulations, many of which are imposed by the government. Nurses and other staff members strive to keep the office running smoothly. A lot of the time, these team members are doing these things without enough financial or staff resources. Adding another task, like screening for SDOH, into the workday can be complicated and cumbersome. Not to mention the burden once hundreds of patients are identified as needing assistance.
Adding technology to the mix may seem overwhelming at first, but it can help streamline the office operations and improve patient satisfaction. As we mentioned in a previous blog, one report noted that the adoption of SDOH technology is expected to grow 12-15 percent by 2023.
athenaNet at Work
As an Athena user, you have access to powerful technology. One such tool is Epion Screener, which is automated and integrated to capture 100 percent of your screening opportunities. This includes SDOH.