healthcare benchmarks and etrics march 2017 social … · 2017-03-15 · healthcare benchmarks and...

Healthcare Benchmarks and Metrics March 2017

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Social Determinants of Health in 2017:

Scarcity of Supportive Services Hampers SDOH Linkages

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March 2017 • Social Determinants of Health in 2017

Social Determinants of Health in 2017: Scarcity of Supportive Services Hampers SDOH Linkages

Evidence is mounting that social determinants of health—social, economic and environmental factors that impact quality of life—significantly influence population health. Research published by Brigham Young University in 2015 determined that the social determinants of loneliness and social isolation pose as great a threat to longevity as obesity. Cognizant of the need to promote social and physical environments conducive to optimal health, more than two-thirds of healthcare organizations now assess populations for social determinants of health (SDOH) as part of ongoing care management.

In findings from the February 2017 Social Determinants of Health survey by the Healthcare Intelligence Network, 68 percent of respondents integrate SDOH screenings into clinical work flows. Of Healthy People 2020’s five key SDOHs—neighborhood and built environment, economic stability, health and healthcare, education, and social and community context—88 percent screen for health and healthcare determinants, including both access to healthcare and health literacy level. However, one-third found population needs to be most acute within the economic stability domain.

So critical are SDOHs that while 46 percent of respondents prioritize high-risk patients for SDOH screening, 40 percent assess their entire populations for these socioeconomic red flags. And while referral to community services is the first SDOH line of defense for 78 percent of respondents, a scarcity of these services limits SDOH resolution for 23 percent.

Most SDOH screenings occur during comprehensive health assessments, say 57 percent, while 12 percent probe for this sensitive data during Medicare Annual Wellness Visits (AWVs). While proprietary and homegrown SDOH screening tools abound, almost a third—31 percent—rely on SDOH questions embedded in electronic health records for this purpose, versus formal SDOH instruments such as the Patient Centered Assessment Method, or PCAM (13 percent), or Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences, or PRAPARE (11 percent).

Survey Highlights

�� In addition to the health and healthcare SDOH domain, 75 percent screen patients for deficits in either economic stability or neighborhood and built environment (including social isolation).

�� Beyond a lack of community services, SDOH follow-up is hampered by patient reluctance to divulge sensitive information, say 21 percent of respondents.

�� Given the nascent nature of SDOH assessment, 84 percent report that it is too early to measure financial returns from these efforts.

�� Ninety-six percent believe Medicare and other payors should reimburse healthcare providers for SDOH assessment and follow-up.

Buy the Complete ReportNeed more data from this survey? 2017 Healthcare Benchmarks: Social Determinants of Health documents efforts of 141 healthcare organizations to assess social, economic and environmental factors and begin to redesign care management to account for these influences. For more information on this report, please visit: http://store.hin.com/product.asp?itemid=5214

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Program Components

�� Nutrition is the leading community or supportive service linked to SDOH interventions for 70 percent of respondents.

�� Beyond community service referrals, 77 percent of respondents offer healthcare system navigation assistance to individuals with SDOH limitations.

�� Forty-seven percent of respondents offer SDOH re-screening and follow-up to the populations they serve.

�� For 28 percent of respondents, an RN case manager has primary responsibility for SDOH interventions.

�� One-third of responding SDOH initiatives link patients to services that address interpersonal violence.

�� One-third of respondents not currently assessing for social determinants of health plan to do so within the coming year.

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Interventions Available to Individuals Identified with SDOHs

© 2017 HIN Social Determinants of Health Survey: February 2017

http://hin.com/blog/2016/12/13/use-annual-wellness-visit-to-screen-for-social-determinants-of-health-in-high-risk-medicare-population/

http://hin.com/blog/2017/01/12/social-health-determinants-does-technology-connect-or-isolate/

http://www.hin.com/library/registerHomeVisits2017.html

http://www.hin.com/library/registerStratifyingHighRisk2016.html



Results and ROI�� Almost four-fifths—79 percent—of respondents report improved patient

satisfaction or patient experiences that they attribute to SDOH interventions.

�� Two percent reported ROI between 2:1 and 3:1 from efforts to identify social determinants of health; the same percentage experienced program ROI greater than 5:1.

�� More than one-third of respondents report reductions in hospital readmissions as a result of SDOH initiatives.

Most Effective Tools, Protocols and Work FlowsNumerous respondents shared their most effective strategies for SDOH screening:

�� “Utilization of a community resources mapping tool that allows us to pick the area of need and locate appropriate available resources to the member close to their homes.”

�� “Our community health workers who live in the community, go to church and know these individuals as members of their community.”

�� “Client-centered care that focuses on client-identified goals, addresses barriers and supports in the client’s environment (social/attitudinal, financial, physical built environment) that limit participation in meaningful tasks for health/well-being.”

�� “A protocol that integrates into specific providers of care such as managed care organizations, home healthcare agencies, assisted living and skilled nursing facilities to provide virtual visits for high-risk older patients and/or clients.”

About the SurveyThe February 2017 Social Determinants of Health survey was administered via the Healthcare Intelligence Network site at http://www.hin.com. Throughout the month, respondents were invited to take the survey via e-mail, e-newsletter and social media reminders. A total of 141 healthcare companies answered the survey, which asked 24 questions about SDOH initiatives, with multiple responses possible on some questions. Some questions were open-ended, inviting write-in responses. Not all surveys were completed. Data is qualitative, with results compiled by the Healthcare Intelligence Network.

Respondent Demographics

Responses to the February 2017 Social Determinants of Health survey were submitted by 141 organizations. Of 94 who identified their organization type, 25 percent were hospitals or health systems; 12 percent were health plans; 10 percent were disease management or health coaching organizations; 7 percent were physician practices; 6 percent were behavioral health providers; and 48 percent categorized their organization as ‘Other.’

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http://hin.com/HealthSounds/2016/12/20/beyond-housing-chronic-care-plus-connects-medically-vulnerable-homeless-to-social-services/

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healthcare benchmarks and etrics march 2017 social … · 2017-03-15 · healthcare benchmarks and...

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