The first-ever set of measures of social determinants of health has been adopted by the Centers for Medicare & Medicaid Services (CMS).
The measure set, proposed by the Physicians Foundation, was adopted for use earlier this month in the Hospital Inpatient Prospective Payment System rule, effective 2023. It comes as the agency has prioritized implementing measures that reflect social and economic determinants. The currently approved measure set is for hospitals in federal payment programs, which will now be required to report what portion of their population is screened for various SDOH and how many screen positive in each category.
These measures are based on the foundation’s framework for addressing SDOH (PDF), published last year. An optional set is also being considered for physicians separately by CMS, the nonprofit organization told Fierce Healthcare.
“It’s opening up a whole new area for us to investigate and improve the health of the country,” the organization’s president, Gary Price, M.D., said in an interview. Up to 70% of health outcomes are determined by SDOH, and tracking them is the “first step,” he added. “You can’t improve what you can’t measure.”
A 2022 Physicians Foundation survey of providers found that while the vast majority agree that addressing SDOH is critical, 6 in 10 feel burned out in their attempts to do so. Price is hopeful these data will be used to fuel research and creative new solutions to healthcare barriers.
To help with the transition for providers, the Physicians Foundation announced the launch of a new grant program for up to five medical associations. The aim is to help develop state-level resources and data-collection support for physicians incorporating screenings for social drivers of health in their practice. “This is brand-new. There’s a lot to learn,” Price said. The goal is for the screens to become seamlessly integrated into clinical workflows, rather than burdening them further. Each grantee will receive $75,000. Interested applicants can apply online.
Additionally, the organization has introduced a new yearlong fellowship aiming to advance progress on SDOH. The organization announced that this year’s first fellow, Ryan Lowery, M.D., a pediatrician in Texas, has dedicated his work to addressing health equity and social drivers. The foundation hopes to expand fellows’ leadership skills for those interested in addressing barriers to health and expects fellows to help advance research in the area.
When it comes to anticipating hospitals’ reactions to the new measures, Price acknowledged there might be skepticism around any additional administrative burdens. However, he emphasized, most hospitals already collect these data—they’re just not required to report it. Some might also worry they will be scored or judged based on the data, though the goal is to regularly collect the data for research, he said.
“These investments in these things do pay off handsomely in the end,” Price said.