Many hospitals and health systems are working to navigate the challenges of effectively linking community and clinical services to improve health outcomes in the long term. The Deloitte Center for Health Solutions conducted a nationally representative online survey of about hospitals and health systems to identify their current health-related social needs and activities and investments and their potential future efforts. To better understand how hospitals and health systems may be operating in the larger health care ecosystem and the challenges they face, we also interviewed representatives of hospitals, health plans, and nonprofit community organizations.
Hospitals Need Targeted Plan for Social Determinants of Health Hospitals are starting to leverage the social determinants of health to drive value-based care.
The report, which included the results of a survey of nearly hospitals across the country, showed that healthcare organizations believe health is determined by more than clinical encounters and diseases. As a result, 80 percent of hospital leaders support organization efforts to account for the social determinants of health.
Public Health Org Aims to Meet Social Determinants of Health Eighty-eight percent of hospitals are taking action on the social determinants of health by screening patients for social needs — issues ranging from housing assistance to subsidized lunches for school children.
Twenty-six percent of that screening is occasional, compared to 62 percent of hospitals that consistently screen patients.
Although more hospitals are consistently screening patients, Deloitte suggested that more organizations should regularly conduct these screens.
Additionally, hospitals should move away from targeted social screening.
Ninety percent of respondents said they screen all inpatients, and 83 percent said they screen their high-utilizer patient populations. Only 69 percent of hospitals said they screen broad patient populations, a number Deloitte said should ideally increase over time.
The push for more value-based care and risk-based payment models had driven hospital attention toward the social determinants of health, the survey found. Hospitals that are further along in the shift toward value-based healthcare also have more investments in tracking and acting upon the social determinants of health, the report explains.
Hospital investments in social health vary because progress toward value-based care currently varies, the report noted.
Using Social Determinants of Health in Patient-Centered Care Seventy-two percent of hospitals said that they do not have a dedicated fund for their unique patient populations. For the financial resources they do have, most hospitals said they tap into pools of community, state, federal, and private funds to support the social determinants of health.
Hospitals that serve needier patients — non-profit hospitals and disproportionate share hospitals DSHs — do not necessarily have larger social health investments than other hospital types.
Most hospitals are also struggling to adequately measure the efficacy of social health outreach, the report said. Although nearly all respondents said tracking outcomes — cost, clinical, and patient experience — is an important goal for social health, about 40 percent of respondents said they have no capability for tracking outcomes.
Thirty-five percent of hospitals said they measure cost outcomes for their social determinant activities. As value-based care moves forward, so will the imperative for hospitals to track patient clinical and social needs. Most hospitals said activities for the social determinants of health are a moral obligation and they are hopeful that value-based care will continue to push for these activities.
Overcoming Patient Barriers to Chronic Disease Management However, hospitals will need the right skillset and tools to successfully act on social health.
First, hospitals must create a clear definition and set of priorities for the social determinants of health. Hospitals must also consolidate their resources, reduce duplicative social efforts, and create strategies to track clinical and cost outcomes.
From there, hospitals must identify strategies that have proven successful and practice them at a larger scale. Hospitals can fund these projects by sharing success stories to drive investor buy-in. Ultimately, hospitals hoping to continue their efforts in the social determinants of health should look to advance value-based care efforts.
Deloitte experts explained that value-based care and social health are intrinsically linked, and investing in one will help drive the other.In place of formal, institutionalized care, health systems are now making a more patient-centric “shift left” (Figure 3) toward settings where the care goes to the patient, instead of the patient going to the care.
44 These new settings may include a patient’s home, community health centre, school or workplace, and many more locations. Toward Addressing Social Determinants of Health: A Health Care System Strategy. In the US, there is growing recognition that social factors (eg, financial hardship, food insecurity, housing instability) influence individual and population health.
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