Numerous research studies consistently highlight the substantial impact of social determinants of health (SDOH) on individuals’ well-being, accounting for a significant portion of health outcomes, ranging from 30% to 55%. Recognizing the profound influence of SDOH on physical and mental health, healthcare institutions, insurance providers, and government programs have increasingly emphasized the need to gather SDOH data for comprehensive patient care.
The Joint Commission, a nonprofit organization responsible for accrediting healthcare entities, has taken a significant step by updating its accreditation standards. It has introduced a new element of performance (EP) that specifically focuses on screening for SDOH. Consequently, healthcare organizations must now evaluate patients’ social determinants of health and devise plans to address any identified needs.
Similarly, the Centers for Medicare and Medicaid Services (CMS) have also acknowledged the importance of addressing SDOH. In January 2021, CMS introduced the Community Health Access and Rural Transformation (CHART) Model. This initiative aims to enhance healthcare access and tackle social determinants of health, particularly in rural areas. Through the CHART Model, CMS seeks to support community-driven initiatives, including improved transportation access, housing solutions, and healthier food options.
The integration of SDOH into accreditation standards and value-based care programs by The Joint Commission and CMS underscores the significance of addressing these factors in healthcare. This shift is expected to result in enhanced patient health and reduced health disparities over time.
To adhere to The Joint Commission’s six elements of performance for SDOH in the 2023 calendar year, healthcare organizations should establish a comprehensive framework for collecting SDOH data:
- Leadership: Create a dedicated committee to address SDOH and secure leadership commitment to this initiative.
- Assessment: Employ appropriate screening tools to evaluate patients’ social determinants of health. Health system leaders and informatics leads should understand available tools and regulations, including administrative claims data, electronic clinical data, standardized patient assessments, and patient-reported data and surveys.
- Identification: Identify patients with unmet social needs and prioritize those requiring intervention.
- Intervention: Develop actionable plans to tackle identified social determinants of health and provide necessary support and resources to patients.
- Evaluation: Routinely assess the effectiveness of intervention plans and make improvements as necessary.
- Communication: Facilitate effective communication among all stakeholders involved in addressing SDOH, including patients, healthcare providers, and community organizations.
For CMS’s voluntary reporting of SDOH in the inpatient sphere in the 2023 calendar year, healthcare organizations can begin reporting on a voluntary basis. However, starting in January 2024, reporting will become mandatory, with a submission deadline of May 15, 2025.
In 2024, CMS mandates the screening of five specific SDOH domains for admitted patients:
- Food Insecurity
- Interpersonal Safety
- Housing Insecurity
- Transportation Insecurity
- Utilities (a new domain, categorized under financial insecurities)
To ensure a unified approach across various healthcare settings, including ambulatory care, emergency departments, inpatient care, and home health services, healthcare organizations should coordinate their efforts in addressing SDOH.
Additionally, CMS will introduce two inpatient quality reporting measures for SDOH in 2024:
- Screening for SDOH: This measure assesses the number of patients screened for the five domains of SDOH for individuals aged 18 years or older.
- Positive rate for SDOH: This measure tracks the number of patients who tested positive for any of the five domains of SDOH.
In conclusion, addressing social determinants of health is increasingly vital in healthcare. The emphasis placed on SDOH by both The Joint Commission and CMS necessitates that healthcare organizations establish comprehensive frameworks for collecting SDOH data and crafting intervention plans. By doing so, hospitals can provide holistic care to their patients, leading to improved overall health outcomes and a reduction in health disparities.