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Focus on health equity intensifies, but much more work needs to be done

African American Doctor With Face Mask Examining Boy's Throat During A Home Visit.

Upfront’s VP of the Bartosch Patient Activation Institute, Lindsay Zimmerman, shares her takeaways from the KLAS SDOH Summit, as enterprises look to shape the future of social determinants of health programming  

I recently returned from the KLAS SDOH Summit, where I had the opportunity to meet and exchange ideas with like-minded innovators focused on leveraging data and technology to improve health equity.

In addition to forging new relationships and gaining new insights into how others are addressing health equity in the healthcare space, I was able to lend our voice to the important discussions that are helping shape the KLAS SDOH Framework and how the organization should think about technology vendors’ role in addressing health equity alongside patients, payers, providers, NGOs, and policy groups. Following is a summary of my key observations from the conference:

Focus on health equity is growing across multiple stakeholders, but a cross-sector approach is needed to move the needle

There are clear signals that health equity is becoming increasingly important to multiple stakeholders in healthcare including payers and providers. There, however, is still much work that needs to be done to build cross-sector partnerships to develop solutions to address the social, structural, and societal drivers of health and develop social care interventions. The success of social care interventions will only occur through collaboration with NGOs and other organizations embedded in our communities that have been addressing inequities in our society for decades.

Patients with lived experience must be included in the design and implementation of new programs to ensure they are valuable in providing all patients with the care they need and deserve. To facilitate these cross-sector collaborations, funding is needed both for capacity building and actual social care delivery.  

There have been considerable advances in capturing information on the social, structural, and societal drivers of health

Data is needed to identify opportunities to improve health equity and measure progress after the implementation of social care programs. 

There has been tremendous movement on the data/metrics front through the formations of collaboratives like The Gravity Project focused on defining standards for how we use information on the social drivers of health. 

Additionally, federal agencies are incorporating metrics into payment and quality reporting programs—like the new HEDIS® Social Need Screening and Intervention Measure – and developing care models that include addressing social needs as a key tenant like ACO Reach. 

Health systems and payers are also putting more focus on data aggregation and insights generation. In addition, more evidence is accumulating about how addressing social care needs affects health outcomes and leads to ROI like this.

Equity has to be prioritized

We talk about the importance of improving health equity, but are still not centering equity in all the work we do. Equity cannot be an afterthought. We are either actively promoting and centering equity or passively perpetuating inequity and causing harm.  

Placing the blame on patients must stop

Patient behavior is shaped by the social, structural, and societal drivers. While there is increasing recognition that this is true, this lens is still not embedded in how we deliver care and communicate with patients. 

Too often we still talk about “non-compliant” patients instead of considering the reasons why patients are not supported and empowered to get the care they need or adhere to recommended care plans.  

Key assumptions should be challenged

The assumption that all healthcare involvement in addressing the social, structural, and societal drivers of health is good may not be true. Among the reasons:  

  • The medicalization of social problems makes everything costs more when it goes through the healthcare system. 
  • Healthcare systems typically don’t have the same community relationships other stakeholders have. 
  • Capacity is limited to focus on social care interventions, in addition to the delivery of clinical care. 
  • Addressing individual social care needs is different from addressing the underlying social and structural determinants that lead to social risks and care needs. 
  • It’s unclear whether recent CMS initiatives are actually helping.  

ROI of addressing social care needs must be more holistic

Healthcare stakeholders are not being held accountable—nor are they incentivized—to address health equity for the long term. The focus of many leaders is on proving ROI in the short-term, which is fundamentally not going to show results for solving these types of problems. 

A more cohesive view of ROI is needed, including the economic value to society and our communities/the cost of letting inequity persist in the long-term. Financing social care interventions requires capacity-building funds for developing partnerships and ongoing service delivery, which is challenging in both capitated and FFS arrangements.  

Contracts should be structured differently so that we’re not focused on “quick fixes,” and potentially share savings across multiple stakeholders (vendors, payers, and providers).  

Upfront: Amplifying health equity strategies 

It is exciting to see how much healthcare has begun to focus on health equity in recent years, but we still have a tremendous opportunity to better serve patients and our communities. Vendors, like Upfront, have a responsibility to think more cohesively about our role in improving health equity and how we can amplify the strategies and initiatives of stakeholders like providers, payers, NGOs, and policy organizations. 

These cross-functional collaborations, and more discussions like those at the KLAS SDOH Summit, are the only way we will be able to remove patient barriers and ensure all patients have the care they need and deserve. 

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