Social Needs and Health
Specific examples are educational attainment, socioeconomic status, housing situation, food security, family and social network, and access to transportation. Researchers and clinicians agree that if a patient cannot afford treatment, has limited access to health resources, and is subject to environmental stressors, the clinical effectiveness of care decreases, costs go up, and morbidity and mortality rates increase.
How to Address Social Needs through the Healthcare System
Simply recognizing these factors without addressing them head-on is not adequate. CMS is changing its policies to allow Medicare Advantage plans to cover certain services that would address beneficiary social health. An example of a design that includes social care is a Medicare Advantage plan offering a transportation benefit, food allowance, and gym membership at no extra cost to the member.
To continue to address social care needs, healthcare organizations must design programs that are evidence-based to begin the hard work of addressing social risk factors. Often, this means creating partnerships outside of the traditional healthcare service providers, including faith-based organizations, community organizations, the educational system, and employers.
Healthcare delivery systems can seek out and nurture strategic partnerships with community-based organizations in order to be successful going forward. However, the nature of these partnerships may be quite different than traditional partnerships. This partnership approach is new territory for many healthcare professionals.
One principle of the system theory that must be re-emphasized is that the system boundaries are artificially imposed. Understanding and accepting that there is continuity between what we traditionally consider the healthcare ecosystem and what extends beyond it helps to break down artificial barriers that appear to limit healthcare industry solutions.
Social Care and Value-based Care
The move to value-based payments, consumer-driven markets, and patient-centered care will weaken the traditional healthcare system hierarchies. The healthcare organizations that recognize this and embrace new nontraditional strategic partnerships can continue to be relevant in meeting community needs and in meeting their mission in a healthcare market landscape that no longer is based on fee-for-service paradigms.
Additionally, meeting the diverse needs of communities and specialized populations through community programs and partnerships allows competition through innovation creating multiple winners with positive-sum gains. Healthcare at its core is to serve patients and their needs. Patients have a diverse set of needs in today’s market. Healthcare business designs that incorporate community assets will reach mission-affirming sustainability and drive positive health outcomes.