Unmet Social Needs and the Importance of Addressing Them

Addressing the unmet social needs of patients requires additional investment on the part of the healthcare industry, but provides a tangible return on investment. At America’s Health Insurance Plans’ 2016 Institute & Expo, held June 15-17, 2016, in Las Vegas, Nevada, Rocco Perla, president of Health Leads, and Karin VanZant, executive director of Life Sciences at CareSource, discussed the business case for addressing patients’ unmet social needs.

Perla led off the session with data from Massachusetts General Hospital that affirmed that addressing unmet social needs can improve blood pressure and LDL. He stated that “social comorbidities are an inescapable reality of your members’ lives.”

However, there is continued market paralysis around addressing patients’ social needs.

“We will find it hard to achieve health economic reform if we don’t address patients’ lives outside the clinic,” Perla said.

And while the healthcare industry collects an immense amount of information, there is a lack of data on patient social needs because it is not collected regularly. The solution is fairly easy: add 5 questions to health risk appraisals and build it into care management systems and electronic health records.

Addressing patient social needs is becoming even more important considering the government’s move to address these issues. CMS’ Accountable Health Communities will pay for screening for social needs and directing patients to community services that can assist them. The Comprehensive Primary Care Plus model is designed to help providers think about how to serve patients’ needs outside of the doctors’ office.

“These programs signal a dramatic shift in the healthcare landscape and take a broader view,” Perla said.

VanZant outlined the Life Services model, a voluntary program that addresses social determinants of health. In order to make a sustained impact when serving low-income members, it is important to realize that for many Medicaid recipients healthcare is low on the list of things that they consider pressing issues.

She also emphasized the importance of collecting data.

“The disheartening part of collecting data from our members is that many of our members have 5 or 6 case managers, social workers, community coordinators, and more in their life that aren’t talking to one another,” VanZant said.

However, because these individuals have so many other organizations they work with, they are used to answering questions about the housing they have, the condition of their housing, what programs they receive assistance from, and more.

CareSource has identified 5 pillars of social determinants of health: economic stability, housing and neighborhood, education, social relationships, and food and nutrition. It’s important for patients to have access to all 5 pillars otherwise it won’t matter if they meet with their physician and take their prescriptions if their house is literally falling down and there is violence in their neighborhood and their children are in bad schools, VanZant explained.

“We have to take into consideration that our members have just as limited amount of time as we all have,” she said. “That they sometimes have more critical decisions that they have to make on a day-to-day basis that can be the difference between putting food on the table or not.”