Knowledge Expansion

MGMA19 Session Spotlight: Utilizing social determinants of health data to achieve value-based care success

Insight Article

Christian Green MA
According to the World Health Organization, “Social determinants of health are the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics.”

Although many providers recognize the need to address SDoHs to improve care delivery, health outcomes and transparency, it’s often difficult to determine where to start. That’s where Shaheed Koury, MD, MBA, FACEP, vice president for quality and clinical transformation, CHSPCS-Community Health Systems, Franklin, Tenn., and Stephen Stewart, partner, CareHarmony, Inc., Brentwood, Tenn., come in. 

As Stewart says, making use of SDoH data is not only good for patients, it’s also a sustainable business model. He notes that his organization works with many accountable care organizations (ACOs) and hospitals, and it’s vital for everyone from chief medical officers to chief financial officers to understand how to leverage SDoH data to achieve value-based care success.

“The biggest myth we’re trying to debunk is that the social side of healthcare is something that can’t be solved,” Stewart says. “Every doctor we talk to expresses the need for this; they just don’t think there’s anything you can do about it.”

Part of the answer lies in looking beyond healthcare as a means to help organizations thrive. “By getting community-based organizations involved, you can actually deploy interventions that improve both clinical and financial outcomes,” Stewart contends. For patients, this could potentially lead to fewer trips to the emergency department, cheaper medications, easier access to transportation, etc.

“Nowadays with CMS [the Centers for Medicare & Medicaid Services] adding all of these additional care coordination programs and … trying to get providers into risk to try to teach them to be more like a payer, whether that’s an ACO or bundled payments — that’s what we’re trying to disprove,” Stewart says of his desire to explain how SDoH data can be used effectively in value-based care models.  

“Whether you are a small solo doctor or a very large, multi-billion-dollar health system, these programs are available to you and you can help your patients immediately and really connect that community,” Stewart insists.

About the Author

Christian Green
Christian Green MA
MGMA Writer/Editor MGMA

cgreen@mgma.com

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