New levels of engagement and collaboration are needed to address the nonmedical factors that impact people’s health, according to a report published by the Healthcare Financial Management Association (HFMA). These nonmedical factors, known in industry circles as social determinants of health, include nutrition, housing, transportation, education, employment, safety and social services, among others. Taken together, social determinants account for up to 80% of a person’s health status.
The report was based on a conference held in Washington, D.C., this fall and attended by more than 100 healthcare thought leaders who shared their knowledge and expertise in a series of small group discussions. The conference was convened by HFMA in partnership with the Alliance of Community Health Plans (ACHP), the American Association for Physician Leadership (AAPL) and the American Organization for Nursing Leadership (AONL).
During the conference, participants underscored the importance of establishing trust with patients, securing patients’ commitment to engage in needed steps and implementing shared decision-making.
“Healthcare is inherently complex at all levels,” said AAPL CEO and President Peter B. Angood, MD, FAAPL(Hon). “Shared decision-making at the patient care level is obviously pivotal, but shared decision-making within all aspects of the delivery system is equally critical if we are going to have social determinants in healthcare become better managed and coordinated overall.”
In addition to engaging patients, conference participants emphasized interorganizational collaboration as a key to success. Partnerships between health systems and health plans or community service agencies are often the most financially sustainable approach.
“Funding sources can be a major obstacle for health systems that would like to take an active role in addressing social determinants of health,” said HFMA President and CEO Joseph J. Fifer, FHFMA, CPA. “For that reason, partnerships between health systems and health plans, which can realize savings by impacting social determinants, make good sense.”
Among the successful health plan-sponsored programs highlighted at the conference was a food delivery service implemented by Health Plan Partners, which was credited with a 28% reduction in hospital admissions and a 7% reduction in emergency department use over a two-year period.
“Deeply rooted in their communities, ACHP member health plans have taken a lead role in developing complex initiatives that address social determinants of health. But no one entity can do it alone,” said ACHP President and CEO Ceci Connolly. “Trusted community-based partnerships are critical to identifying and effectively addressing the underlying social factors affecting health. The most impactful interventions bring together health plans, providers, governments and communities to improve the health of populations and ultimately lower the total cost of care.”
Nutrition was cited by 30% of conference participants as the social determinant with the biggest influence on healthcare costs in the areas they serve. However, participants also recognized the importance of gaining a better understanding of the specific needs in their communities through tools such as community health assessments and screening questions specific to social determinants.
“Collecting and utilizing data on how the social determinants of health affect a community is critical to advancing population health and improving clinical decision-making and the patient experience at lower cost,” said AONL CEO Robyn Begley.
Other topics addressed in the report, which is available through HFMA, include identifying effective strategies for addressing social determinants and overcoming obstacles.
The conference was sponsored by Global Healthcare Exchange, Inc. (GHX), Intuitive Surgical, AbbVie, Inc., BKD, Inc., Baker Tilly, Mapstone Veritas, nThrive and PatientCo.