Financial investment in SDOH is not all it will take to help patients

• Fourteen of the nation’s largest health systems recently announced a commitment of $700 million toward community-based initiatives aimed at addressing the economic and environmental drivers behind a widening disparity in health outcomes. 
• Most of the dollars will go to providing affordable housing with each participating health system submitting annual data to provide metrics to track their activities. 
• While these efforts are laudable, addressing social determinants will require more deliberate integration, linking of efforts and data sharing to manage interventions for patients.

Fourteen of the nation’s largest health systems recently announced a commitment of $700 million toward community-based initiatives aimed at addressing the economic and environmental drivers behind a widening disparity in health outcomes. The health systems are part of the Healthcare Anchor Network, a collaborative of 45 leading hospitals and health systems who have committed to a goal of impacting determinants of health and build inclusive and sustainable local economies through community investments.

Most of the dollars will go to providing affordable housing with each participating health system submitting annual data to provide metrics to track their activities. There is strong evidence, as shown by a literature review by the Commonwealth Fund, to show that supportive housing can reduce healthcare costs. UnitedHealth knows this as well and has committed to its own effort in addressing social determinants of health by hiring and tasking Jeffrey Brenner, M.D., with providing supportive housing to 350 homeless Medicaid patients. This initiative is an effort to reduce the $17 million UnitedHealth spends on medical care for that population.

These efforts highlight what may be a growing commitment from healthcare stakeholders to address social determinants of health. The U.S. has been critiqued in the past for lacking the investments in social risk issues compared to other countries, although a more recent Health Affairs research article indicated the U.S. may actually be more on par with others as far as percent of GDP.

Takeaway

While these efforts are laudable, addressing social determinants will require more deliberate integration, linking of efforts and data sharing to manage interventions for patients. I like the point raised by authors authors Judith R. Peres and Gerard F. Anderson in their response to the study in a Health Affairs blog that without any single entity taking responsibility for addressing the range of medical and social service needs there are still great inefficiencies in the way healthcare and social interventions are delivered. The lack of clearly defined roles and responsibilities for the myriad of healthcare stakeholders was a common frustration voiced by participants at HFMA’s recent Thought Leadership Retreat.

Collecting data and tracking outcomes on these initiatives will be key so that healthcare systems can move to one that can be sustained by keeping people healthy.

Perhaps these efforts are part of a larger shift in our culture in the United States where organizations are committing to building an economy that serves all, or perhaps it is simply an effort by hospitals and health systems working to share in savings under value based contracts. No matter the driver or incentive, it is the right thing to do as far as the patient and communities served are concerned.