Value-based care is allowing hospitals to better align clinical care with social needs, but many health systems are struggling to “fund and build effective capabilities,” according to a new survey by the Deloitte Center for Health Solutions.
The survey of 284 U.S. hospitals found they are still learning how to benefit from coordinated care and value-based payment models.
Deloitte also found that 80% said hospital leadership is committed to addressing social needs as part of clinical care, 90% are screening inpatients and 83% are screening high-utilizer populations for social needs. Nearly 40% said they have no way to measure the outcome of their activities pertaining to value-based care.
Deloitte said environmental and social factors impact health and determine 80% of health outcomes. However, hospitals don’t know how to integrate that into treatment protocol, according to the report.
Sarah Thomas, leader of the Deloitte Center for Health Solutions, said hospitals are trying to help patients connect to programs that can address their needs, but they still struggle with knowing what programs work best for specific patients. Nearly three-quarters of hospitals surveyed said they don’t have dedicated funds for the populations they want to target.
Hospital leaders support the move to a value-based system, but the problem is that many healthcare executives still don’t plan on having any value-based reimbursement initiatives. Also, it's unclear how effective those models are at reducing healthcare costs and improving quality.
Deloitte offered some possible solutions, including: adopt consistent definitions and metrics addressing social determinants of health; scale what is working; remove silos and consolidate resources; continue the push toward value-based care; find ways to track health and cost outcomes; and share best practices so hospitals can invest in programs that work.
Reducing disparities is a major issue in U.S. healthcare. Medicaid expansion has led to more insured Americans, but issues involving housing, education and nutrition still have a “substantial effect on people’s health.” A recent Commonwealth Fund study found that the U.S. healthcare system ranked last in system performance of 11 wealthy nations. One of the many areas in which the U.S. came in last was equity in healthcare.