Skip to main content

How partnership, data and analytics can help supercharge SDOH outcomes (part 1 of 2)

Partnership has always been essential to achieve healthcare's aims. And where there's a will — and a pandemic — there's a way. To find the way, hospitals and community-based organizations must partner in new ways to incorporate social determinants of health into patient care improvement efforts. Rich new SDOH data sets can supercharge the design, implementation and evaluation of SDOH initiatives as providers are expected to assume more responsibility for outcomes related to non-clinical factors. 

The impact of social determinants of health 

The pandemic resurrected a statistic that has been around for some time: 80% of health outcomes are based on social determinants, with only 20% dependent on clinical care. 

People naturally understand it is harder for someone to manage their diabetes without access to affordable, healthy food. Through the federally-required Community Health Needs Assessment process, hospitals understand local need, but many do not yet know how to shift from a longstanding clinical focus to incorporating SDOH into program design and total cost of care. The coronavirus pandemic has forced a rapid pivot in this direction that would have otherwise taken years to achieve.

Managing total cost of care is essential for value-based care and to achieve healthcare's Triple Aim: better population health management, patient experience and cost control. But the Triple Aim has never explicitly included health equity. A January 2022 article from the Journal of the American Medical Association has called for this very thing, stating, “It is tempting to argue that health equity is already covered in 2 of the aims, better experience of care and better health for populations. But neither is guaranteed unless health equity is made an explicit goal.” The authors add that “quality improvement without equity is a hollow victory.”

With providers now called upon to be a proactive part of SDOH solutions, hospitals and health systems are in a unique yet challenging position to make a difference. Their charge is to support health equity through program sponsorships, collaboration, education and advocacy, all informed by new SDOH data and analytics resources.

The unique role (and challenges) of hospitals and health systems

It doesn't take an exponential funding increase to get started. Even before funding is identified, communication and partnership with community-based organizations are vital and must be guided by what DataGen defines as the Discover-Plan-Act cycle.

The “Discover” phase involves gaining insights using reliable sources of data and proven methods of analysis. A base of meaningful analysis can serve as a tool and prelude to working with CBOs. As the JAMA article puts it: “Quality improvement efforts should . . . [involve] persons from groups and communities that are affected in the planning, designing, and delivery of interventions so they are inclusive, culturally sensitive, and structurally appropriate.”

Please stay tuned. In our next blog, we will further explore how to take the next steps through high-quality alternative SDOH data sources.

Comments

Popular posts from this blog

BPCI Advanced – take advantage of the model extension now

The Bundled Payment for Care Improvement (BPCI) Advanced Model is now open for applications until May 31, 2023. This model provides a unique opportunity to acute care hospitals and physician group practices who are looking to: evaluate their bundle performance; rejoin if they have previously dropped out due to being under a convener; or take advantage of the changes to the model. With a small window to sign the participation agreement, you’ll need experts to process data quickly and accurately for evaluation. BPCI Advanced Program Details The Centers for Medicare & Medicaid Services (CMS) announced in October 2022 that this program will extend from January 2024 to December 2025. Data used for evaluation will be taken from the baseline period between October 2018 and September 2022. A participation agreement will be sent out in September 2023 and needs to be signed by October 2023 in order to participate. Those who apply before the May 31 deadline will benefit

BPCI Advanced Model Extension

CMS recently made several major announcements about the Bundled Payments for Care Improvement Advanced Model.  The model, which was due to expire at the end of 2023 (Model Year 6), will be extended for an additional two years through Dec. 31, 2025.  New applications will be accepted in 2023 for the two-year extension. Participants still active in Model Year 6 can continue without reapplying by signing an amended and restated participation agreement for Model Year 7.  New methodological changes will be implemented for Model Year 6, which starts on Jan. 1, 2023. Methodological changes include that: the CMS Discount Factor for medical clinical episodes will be reduced from 3% to 2%;  the Peer Group Trend Factor Adjustment cap for all clinical episodes will be reduced from 10% to 5%; the Major Joint Replacement of the Upper Extremity clinical episode category will become a multi-setting episode category by allowing episodes to be triggered when the procedure is performed in the hospital ou

You’ve been accepted to the Enhancing Oncology Model. Now what?

The Centers for Medicare and Medicaid Services Innovation Center recently announced approved applicants for the new Enhancing Oncology Model. If your facility has been selected by CMS, are you still weighing your options during the current baseline evaluation period?  Two deciding factors may include the program data that CMS provides and whether EOM is enough of an improvement over the prior Oncology Care Model to make your investment worthwhile. Another factor to consider: Will you have the resources in place to conduct a baseline evaluation before EOM’s program start on July 1, 2023? How EOM differs from OCM EOM aims to improve the coordination of oncology care, drive practice transformation and reduce Medicare fee-for-service spending through episode-based payment. It includes three major updates: Fewer cancer types. Compared with OCM’s 21, EOM will be limited to seven common cancer types: breast, prostate, lung, small intestine/colorectal, multiple myeloma, lymphoma and chronic le