There’s no way around it–healthcare in the United States is expensive. This country spends about twice as much per person compared to other developed nations.
One key way healthcare organizations are addressing these issues is factoring in social determinants of health (SDOH). The World Health Organization defines SDOH as “the conditions in which people are born, grow, live, work and age” and notes that “these circumstances are shaped by the distribution of money, power and resources at global, national and local levels.”
Factors that determine the health of a population include biological, behavioral, social, physical and access to healthcare services. Examples include not having easy access to a high school education or vocational training, being unable to afford nutritious food or living in poor conditions.
Effects of High Healthcare Costs
The issue of SDOH affects many people’s abilities to obtain appropriate healthcare services, as shown in the following statistics:
- Rates of preventable, chronic diseases are rising in low-income communities.
- Studies have found that individual behavior, often spurred by SDOH, accounts for up to 40 percent of the risks for premature death.
- The average life expectancy in low-income communities is 15-20 years shorter than those in higher-income communities.
- The U.S. spends less on social services than any other developed nation, ranking twenty third out of 24 developed nations.
- Research shows that clinical care accounts for only 20 percent of health outcomes; the rest is determined by socioeconomic, behavioral and environmental factors.
A Broader Focus on the Issue
Many healthcare organizations in the United States are expanding their focus on SDOH and its effect on patient care, shifting to value-based care as a solution. A Deloitte Center for Health Solutions survey found that 88 percent of the 300 hospitals and health systems it polled were committed to addressing social determinants and screening patients for social needs.
These types of undertakings are the start of SDOH initiatives in the healthcare industry. However, it must be approached as an ecosystem that involves hospitals and health systems working alongside health plans, the government, community organizations and employers.
Some healthcare providers are investing in additional staff and other resources to zero in on SDOH to improve health outcomes, reduce emergency department and inpatient care visits, decrease downstream medical costs and maximize clinical quality. One report noted that the adoption of SDOH technology is expected to grow 12 to 15 percent by 2023. Examples include analytics tools, EHR integration and population health management.
Utilizing data analytics allows providers to examine corresponding factors of patients’ behaviors and health issues. Data analytics can explore SDOHs of a specific population to target initiatives, help improve risk stratification and gather data on non-clinical factors.
By integrating social determinants of health into EHRs, providers are better able to work with patients through proactive interventions and preventive care; the goal is to improve factors that may negatively affect their health. Through a combination of population health management and the study of SDOH, providers can better mitigate chronic disease treatment costs, decrease preventable hospital readmissions and ensure patients receive the quality healthcare they need.
According to a brief from the Kaiser Family Foundation, the best option for achieving whole health across all populations is “offering healthcare that provides a suite of customizable and flexible solutions that make adding additional services simple, all the while easing administration tasks for health plans.” A recent study found that more than 80 percent of payers are integrating SDOH into their member programs. Though interoperability is an ongoing challenge, health plans and payers can utilize a variety of methods to further the SDOH mission.
The Association of Health Insurance Plans (AHIP) believes health plans and payers can do this by helping to coordinate housing, employment, education, food services and preventive and prenatal care. They also can partner with community leaders to identify top determinants, offer early childhood support services, establish outreach programs and improve access to case management services. These actions benefit health plans and payers by reducing their future spending, decrease long-term negative outcomes for members and lower utilization rates for direct healthcare.