Social determinants of health (SDOH) play a significant role in how your members seek, respond to and carry through with care. When members face challenges related to SDOH, they can impact everything from health care costs to utilization and health outcomes. As a result, Medicare plans are turning to SDOH screening to identify and mitigate SDOH, resulting in more engagement, improved health, and cost savings.
To truly address SDOH in Medicare populations, you need to identify your population’s holistic needs. Only then can you develop the specific interventions to deliver support to your members. In this post, we’ll discuss the challenges to implementing SDoH screening and the tools to overcome those challenges and the benefits of the plan.
The AMA STEPS Forward™ module Social Determinants of Health: Improve Health Outcomes Beyond the Clinic Walls looks at why addressing social determinants of health beyond clinic walls is crucial for achieving health equity. “If we’re really going to get to health improvement broadly in this country, it’s going to be when we marry what we do in the office with work our organizations might be able to do in the communities to improve the conditions under which people live, work and play that actually determine health,” said David Ansell, MD, MPH, senior vice president for community health equity and internal medicine physician at Rush University Medical Center in Chicago.
Why is SDOH screening challenging?
SDOH describes the social environmental conditions in which a person is born, lives, learns, works, plays, worships, and ages. As such, they affect every part of a person’s life, including their physical and mental health. Gathering this type of data about members is difficult to do.
Different areas of the health care system acquire SDOH information such as providers and MCOs. It's challenging to put it together in a cohesive and actionable way.. Some plans are incentivizing clinicians to report this information through claim coding by using Z codes. Many plans have incorporated SDoH screening into their overall health risk assessment process. Some plans are using technology to gather the data which flows into the member’s electronic record.
Another problem is how screenings ask questions. Depending on literacy levels, language proficiency, and comprehension concerns, they can be confusing to certain members. Even if the questions are simple, you can’t guarantee that member answers will reveal the primary SDOH components.
These challenges aren’t insurmountable. With the right tools and strategies, Medicare plans can get a clearer, more holistic view of individual SDOH needs.
Screening for SDOH: Tools and strategies
The means of screening members for SDOH can include high-tech and individual interaction options to collect answers:
Gather member SDOH data manually.
The health care system has long depended on one-on-one touchpoints to gather SDOH information. Care managers and social workers are on the front lines, interacting with members regularly. They can be successful at collecting information that acts as a screening mechanism.
The challenges with this approach are that it’s expensive, hard to scale, and requires a level of trust. When a care worker asks SDOH questions, patients may be less forthcoming about access, interpersonal safety, and food and housing insecurity.
The data gathered from these interactions can be valuable if it’s accurate and can be digitized into the member’s electronic record. However, Medicare plans have realized this isn’t sustainable and turned to technology.
Conduct SDOH screenings that leverage technology.
Interactive apps can be an excellent tool to ask the right questions about SDOH. However, just having an app doesn’t guarantee participation. Several things influence a member’s ability to engage, including tech-savviness, chronic loneliness, or a misunderstanding about why and how to use the tool.
Because engagement is key to screening with technology, you’ll need to:
- Build a plan for communications with members about how and why to screen.
- Incentivize screening participation.
- Involve friendly, personable tech that treats members like humans.
- Ensure ease of use in the app, which you can enhance with chatbots or customer service that guide members through the questions.
5 MCO advantages from SDOH screening
With adequate tools to enable SDOH screening, you can achieve many benefits for your plan and members. Here are some examples:
- SDOH screening helps plans align members to specific programs offered by the MCO. : A blanket approach to SDOH isn’t practical or effective. Being able to get more granular provides plans the data to make more personalized recommendations.
- Periodic re-screening of individuals enables you to measure the effectiveness of programs provided at initial screening. What was a problem last year may no longer be, but new ones may arise.
- Cultivating trust and asking questions in a neutral way provides better responses: What and how you ask matters because members won’t always be forthcoming. Members need a level of comfort before they reveal private or potentially embarrassing information.
- Uncovering SDOH in screening provides plans a way to intervene to avert high-cost services.: For example, if a member’s health history shows multiple trips to the emergency department (ED), that may indicate transportation and access to less expensive services as a concern.. Providing education and communication around accessing primary care with transportation support could decrease the member’s utilization.
- Making chronic loneliness screening a part of SDOH can tackle engagement issues: In considering SDOH solutions, health plan respondents to a study cited social isolation and loneliness as a primary focus. Thus, screening for these loneliness in SDOH discovery is imperative.
SDOH screening: Innovative options can close the gap
For SDOH screening to be meaningful and improve outcomes, your plan should incorporate assessment and intervention for social isolation and loneliness.. We treat loneliness as a chronic condition and one of the SDOH factors. By engaging with friendly technology and compassionate humans, our solutions can mitigate loneliness. If you solve loneliness, you will also solve many other issues.
Learn more about the connection between loneliness and SDOH screening in Medicare members.