Survey: The biggest obstacles health systems face in adopting SDOH programs

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A lack of direct reimbursement and a failure to determine a return on investment are the top reasons a survey found hospital systems don't adopt social determinants of health programs. (Getty/utah778)

Lack of money and an inability to prove an ability to make money are the top reasons hospitals aren’t pursuing social determinants of health (SDOH), a new survey found.

A survey of 200 health system executives released from consulting firm Advis and provided first to FierceHealthcare found that a majority of hospitals surveyed were screening patients for SDOH. But major headwinds such as little to no direct reimbursement are standing in the way of implementing programs and services to address those factors.

“So many providers are dealing with, 'How do we keep the doors open?'” said Bryan Niehaus, vice president of Advis.

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The survey found 85% listed little to no direct reimbursement as a reason for not implementing social determinants programs. Another 63% said that an inability to prove a return on investment was the top obstacle. Respondents could pick more than one obstacle in the survey.

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However, nearly 57% of survey respondents said they work for organizations that screen for SDOH, which can vary from transportation problems to a lack of food or housing.

The survey also asked respondents to list what action will most help healthcare organizations address social determinants. Top responses include public policy changes supporting SDOH (39%) and direct reimbursement for SDOH (37%).

The Trump administration has employed numerous payment models to reimburse providers for the value of care they provide rather than fee-for-service. However, payment models need to have some alignment on SDOH, Niehaus said. There also needs to be “some agreement with policymakers on what hospitals are well-positioned to get direct reimbursement.”

But money isn’t the only thing providers want to tackle SDOH. The survey found that 12% listed better interoperability standards for sharing data as a key request for policymakers.

The findings come as the Trump administration rolled out on Monday final rules to advance interoperability and make it easier for patients to access their medical data.

RELATED: Humana launches value-based program aimed at SDOH

But some hospital systems are not waiting for more reimbursement to address SDOH.

“There are things that we can and should address now,” said Lisa Pennington, chief of community and corporate well-being for the six-hospital system Cone Health based in North Carolina.

She gave an example of the system’s creation of a new position called the director of transportation. Cone Health also developed new systems to address transportation issues for patients that may lead them to miss key appointments.

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