To really improve patients’ health, address poverty and other social needs, physician group says

Oak Street Health patient and doctor
It's time for healthcare to address poverty and other social needs that impact patients' health, says the Physicians Foundation. (Oak Street Health)

Given the fierce national debate on healthcare, now is the time to address patient issues that go beyond good medical care, including poverty and other social needs that impact health, doctors say.

Those social needs are central to any effective healthcare system, write Walker Ray, M.D., president, and Tim Norbeck, CEO, of the Physicians Foundation, an organization that represents the country’s doctors, in a Health Affairs Blog post.

“It’s time to broaden our notion of health if we want to truly care for the nation’s patients. Instead of just treating and managing illness, we envision a healthcare system that moves beyond the doctor’s office and supports other crucial patient needs—such as food and housing. We think this common-sense approach—which leads to even higher-quality care at reduced cost with improved outcomes—is shared by doctors across state lines and political persuasions,” they write.

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It’s the message the Physicians Foundation, which represents physicians from all specialties from every state, recently conveyed in a response to the Centers for Medicare & Medicaid Services (CMS) request for comments regarding a “new direction” for the Center for Medicare and Medicaid Innovation. They presented three ideas:

1. Recognize the impact of poverty and other health-related social needs as a guiding principle for how to design and deliver care. Health-related social needs and associated behaviors drive 70% of health outcomes, they say. Healthcare needs to address needs such as safe housing, high-quality food and ensuring people have heat in winter. For instance, a new study found housing instability is a common problem for patients who regularly seek care at community health centers. Doctors have seen patients who are forced to make choices that compromise their health, such as parents who must choose to pay for food or a child’s medication or patients who delay doctors’ visits because the car broke down, they say.

2. Improve care delivery and reduce regulatory burdens on physicians. This can occur by simplifying and consolidating payment and care delivery models, considering patient’s health-related social needs. Models should make it easier to achieve a person-centered system that delivers health, they say. Instead, a study found that for every hour physicians spend on provide direct clinical care to patients, they spend two hours on administrative and regulatory work.

3. Support state-level innovation that incentivizes plans and physicians to support patients with health-related social needs. Many states are already working with physicians in local communities, particularly with their Medicaid programs, to come up with innovative ways to identify and address social needs of patients, they say. CMS’ Innovation Center could, for instance, prioritize Section 1115 waivers to address screening patients for unmet social needs and enable care team approaches, such as reimbursing community health workers.

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The next phase of work for the Innovation Center presents opportunities to realize a broader vision of health that allows physicians and care teams to help patients cope with the realities of their lives, they say.