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Obstacles Health Systems Face In Adopting SDOH Programs

1 year, 10 months ago

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Posted on Mar 10, 2020, 3 p.m.

Lack of funding and an inability to prove ability to make money are among the top reasons why hospitals are not pursuing Social Determinants of Health, according to a recent study; 62% reported that SDOH is outside of the scope and function of their organizations. 

A recent survey of 200 health system executives found that the majority of hospitals surveyed were screening patients for SDOH, but the issues such as not getting enough reimbursement are standing in the way of implementing programs and services to address those factors.

According to the survey 85% listed little to no direct reimbursement as a reason for not implementing social determinants programs, 63% listed inability to prove a return on investment as the top obstacle; respondents were allowed to list more than one obstacle. 57% reported working for organizations that screen for SDOH which can vary from transportation problems to lack of housing or food, while only 30% work for organizations with structured programs. 

When asked which action would help most healthcare organizations to address social determinants the top responses included public policy changes supporting SDOF at 39% and 37% listed direct reimbursement for SDOH.

While money is the main issue it is not the only thing providers want to tackle SDOH as 12% listed better inter-operability standards for sharing data as their key request for policymakers.

The current administration has employed numerous payment methods to reimburse providers for the value of care they provide rather than fee for service, but these models need to have some alignment on SDOH and some agreement on direct reimbursement says Bryan Niehaus who is the vice president of Advis which is the consulting firm that conducted this survey.

“There are things that we can and should address now,” said Lisa Pennington, chief of community and corporate well-being for the six-hospital system Cone Health based in North Carolina who gave an example of the creation of the position of director of transportation and new systems to address transportation issue for patients that may make them miss appointments. 

Responses highlight that need for a change in our social safety net and a restructuring of the entire system to address the many issues that exist ranging from redundant administration positions and processes to pricing as well as level and quality of the support provided for SDOH and how these systems are perceived and supported. 

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This article is not intended to provide medical diagnosis, advice, treatment, or endorsement.

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