While social drivers of health initiatives have existed for years, we have seen health inequities widen during the pandemic, leading to greater social needs across the country. To support better population health outcomes, and bridge the divide between healthcare and community organizations, many stakeholders have advocated for the integration of SDoH into the medical setting. With new policies and regulations in place, greater collaboration between payers, providers, and community-based organizations can exist, leading to more effective, patient-centered care coordination.
Learn about the recent SDoH advancements in policy, technology, and medical terminology and how they will support sustainable social care interventions.
Z codes are continuing to expand
Adding new codes to ICD-10-CM helps payers and providers capture new medical data, assess patient needs, and aid in service reimbursement. It also drives healthcare innovations, which equates to better care. While Z codes were first introduced in 2016, they have not adequately addressed SDoH due to their limited terminology.
Thanks to the efforts of the Gravity Project, the Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) recently approved new SDoH code assignments, which focus on food insecurity, inadequate drinking-water supply, and sheltered/unsheltered homelessness, among others. Transportation insecurity, material hardship, and other SDoH codes are in process of being introduced, assessed, and considered, with new implementations expected in 2022 and 2024.
Continuing to expand Z codes is a critical step in addressing non-medical needs in the medical setting. It will allow payers and providers more flexibility to build value-based models that support whole-person care – and it is an essential step to building a more robust, patient-centered infrastructure.
SDoH policy changes are on the horizon
Policy changes have been transformative in driving SDoH interventions and advancing health equity initiatives. Since 2021 alone, we have seen 139 bills addressing SDoH introduced into Congress, including the Social Determinants Accelerator Act of 2021 which will help states and communities address social needs more effectively.
In addition, 30 members in the House of Representatives launched a bipartisan Congressional Social Determinants of Health Caucus to improve the impact of social services. It is designed to address SDoH for greater well-being in communities.
The Centers for Medicare & Medicaid Services (CMS) is also supporting SDoH initiatives and recently published a white paper detailing their strategies for transforming the health care system, with one objective focused solely on advancing health equity. CMS wants to ensure that all new payment models “require participants to collect and report the demographic data of their beneficiaries and, as appropriate, data on social needs and social determinants of health.”
In addition, CMS is considering two measures for social risk screening for the Medicare public reporting and performance-based payment program: the Driver of Health Screening Rate and the Driver of Health Screen Positive Rate. If approved, these would require screenings of adult beneficiaries for food insecurity, housing instability, transportation problems, utility help needs, and interpersonal safety.
“I think this is a very exciting opportunity... This will allow for the expansion of SDoH quality measures in other Medicaid performance measure areas [and give] a number of states the ability to understand and look at what they may want to adopt at their own level,” said Linda Hyde, Lead Terminologist at the Gravity Project, in a recent Healthify, powered by WellSky webinar.
Integrating non-medical data into existing platforms will require collaboration
The healthcare industry is shifting toward value-based care, but this requires collaboration between cross-sector stakeholders. While there are concerns and challenges with data collection and sharing, this has become a necessity. When social risk data is incorporated into clinical data, more proactive measures can be taken to reduce health disparities and address prevalent social needs.
To aid in this advancement, Health Level Seven International (HL7) has released an Implementation Guide (IG) which explains how to exchange SDoH content, defined by the Gravity Project, using the Fast Healthcare Interoperability Resources (FHIR) standard. This patient-centered technology includes tech specifications that support the following care-related activities: assessments, medical concerns, goals, interventions, and consent.
When SDoH data is incorporated into medical data, payers and providers gain a better understanding of a patient’s overall health, wellbeing, lifestyle, and environment, allowing for more targeted interventions and more optimal health outcomes.
To learn more about the importance of integrating SDoH into the medical system and how you can overcome the challenges associated with cross-sector partnerships, watch our recent webinar now.