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Column | Social Determinants of Health

Addressing today’s healthcare challenges requires the right data

Column | Social Determinants of Health

Addressing today’s healthcare challenges requires the right data


Image of Tammie Jackson

Tammie L. Jackson

Years ago when my son was a toddler, he became very particular about the shirts he wore. The behavior appeared to be so random. He showed no favor for any other piece of clothing — just shirts and for no apparent reason. Was it the color, the material or the fact that one had a truck versus Barney? I did not know. I bought numerous options, but to no avail. Some he favored. Others he did not, but still no discernible pattern. Then one day, I noticed him quietly and soothingly rubbing the satin tag of a shirt he preferred — and there was my answer.

That story reminds me that, if I work without the right data, I may be solving the wrong problem

When social interventions to solve for risk associated with social determinants of health are informed only by two-dimensional data, we are victim to the same dilemma. A health literacy campaign that includes cooking classes might well be a good intervention when managing an attributed, diabetic population with high emergency department utilization. However, if the key driver of variation in outcomes and utilization is access to healthy food and/or affordability, neither the patient nor the provider will reap real benefit from a health literacy campaign.

Another provider might furnish public transportation vouchers to increase adherence to care plans that include follow-up visits only to learn there are safety concerns in the community and/or no available child care.

Instead, we must use available, third-party data about social risk to complement our clinical and claim understandings. We can better utilize data to understand not only the social risk contours of our communities but also to build a more comprehensive view of individuals’ lives — our attributed patients, our members and our employees.

During HFMA’s recent Thought Leadership Retreat, Elizabeth Fowler, PhD, JD, deputy administrator and director of the Center for Medicare & Medicaid Innovation, affirmed the agency’s commitment to transition away from fee for service to value-based care reimbursement models. She also shared the agency’s objectives, including advancing health equity, supporting care delivery innovation and partnering to achieve health system transformation. She also concurred that the pandemic revealed an urgent need to address health disparities and that we need better data to do so.

Such calls to action have given rise and urgency to HFMA’s just cause to solve for the cost effectiveness of health. I am profoundly optimistic that this convergence of acute awareness, empathetic attitudes, urgent priorities and the availability of data, tools and capabilities will foster bold initiatives to forge a brighter path forward where we emerge better than ever before.

As we prepare to celebrate HFMA’s 75th Anniversary in Minneapolis this month and have these discussions, I reflect on previous Chair themes that put wind in my sails — this legacy I am so honored to carry forth. So I “Dare You 2 Move” and “Imagine Tomorrow” where, if we can “Go Beyond” — even “Beyond the Numbers” — “Step Up” and “Show Courage in Leadership,” because “Leadership Matters,” I know we can “Thrive.”

Am I excited about seeing you all in Minneapolis? Oh, you betcha!

About the Author

Tammie L. Jackson, FHFMA, MHA, CHFP,

is a Vice President with TransUnion Healthcare and 2021-22 National Chair of HFMA.

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