Social Determinants of Health: What You Need to Know

Studies have shown over and over that there are disparities in healthcare access and outcomes based on social determinants of health (SDOH) such as income and education level, environment, discrimination, and other factors. In recent years, we have seen attention turn to collecting information from patients regarding these factors and using them to help guide a patient’s care. In specialty settings, this is often seen as less important, and these factors are either not collected or dismissed as unimportant to patient care. This may all change in the near future, however, as CMS turns even more attention to the collection and use of these factors in patient care.

How Can You Incorporate Use of Social Determinants of Health in Your Practice?

Your software contains fields to record many SDOH items in the patient record already, and you are likely to see more in the future as CMS contemplates adding Quality Measures related to this topic to their value-based payment programs. You can find tools to put these SDOH elements into action today at this link. While not all of the tools in this resource list will apply to your practice, it is worth perusing to see what may be of benefit to you and your patients.

Now let’s take a look at the importance of SDOH and what, exactly, they entail.

The Importance of Social Determinants of Health

In FY19, CMS added new targeted ICD-10 Codes to help providers code these SDOH, more information on these “Z-Codes” is available at this link. These codes were added to help CMS begin to collect data on these factors in order to determine how to overcome them. In January of 2021 CMS issued a guidance to states to use information on SDOH to guide development of programs, benefits, and services to improve population health and reduce the cost of caring for individuals affected by these factors.

The focus on addressing SDOH has not lessened, and indeed, we are likely to see an even greater focus on this topic in coming years. The current administration is very focused on this issue and Chiquita Brooks-LaSure, the recently appointed Administrator of CMS, has been passionate about this platform throughout her career.

So, What Factors Constitute Social Determinants of Health?

To encourage providers to see patients as more than a “bundle of medical diagnoses,” CMS is asking them to consider factors other than patient health status when determining treatment and care planning. Understanding challenges faced by patients in their day-to-day environment can help providers design treatment plans that address patients wholistically and realistically. If a patient lives in an unsafe home environment, they may not have the ability to remember to take a medication three times a day. If a patient cannot afford food, they are unlikely to purchase a high-cost brand name medication.

The CDC defines social determinants of health as “the conditions in the places where people live, learn, work and play that affect a wide range of health risks and outcomes.” These include five key areas that encompass many different elements. Key areas include the following:

• Healthcare Access and Quality: Access to healthcare, access to primary care, health insurance coverage and health literacy
• Education Access and Quality: High school graduation rates, language and literacy, enrollment in higher education, and early childhood development
• Social and Community Context: Cohesion within a community, civic participation, discrimination, conditions in the workplace and incarceration
• Economic Stability: Poverty, employment, food security, and housing stability and neighborhood
• Built Environment: Quality of housing, access to transportation, availability of healthy foods, air and water quality, and neighborhood crime and violence

To learn more about these factors, visit the CDC webpage on SDOH at this link.

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