- With the federal government’s shift to value-based payment for Medicare, a new report is calling for more focus on the effect of social determinants on health outcomes.
- The report, which was released Tuesday by the National Academies of Science, Engineering and Medicine, identifies five social risk factors that may impact beneficiaries' care or care experience.
- The findings are likely to intensify debate among those who argue including social factors in risk adjustment enables lower-quality care for riskier patients and reduces incentives to improve.
The social risk factors include: Socioeconomic position; race, ethnicity and cultural context; gender; social relationships; and residential and community context. Any one of these, as well as a person’s level of health literacy, could affect how hospitals and physicians are rated on measures such as medical utilization, clinical care, patient experience, and cost, the report says.
“All other things being equal, the performance of a given healthcare system can undoubtedly be affected by the social composition of the population it serves,” the report concludes. Yet these effects can sometimes be ameliorated through, for example, partnerships between a health system and social services, the report adds.
The report, one of three HHS has asked the National Academies to conduct, makes no recommendations but offers a conceptual framework for how these risk factors impact access to care, outcomes, and costs.
The second report will focus on best practices, top-rated performers that treat high volumes of poorer patients, Modern Healthcare reports. The third will try to identify which social risk factors providers can control, and which ones they can’t.