SDOH, Health Outcomes & Your Bottom Line

There is a growing understanding that the health of a population extends beyond the physician’s office and the care received. Social determinants of health (SDOH) can have significant impact on the bottom line of healthcare providers and organizations as well. Our current healthcare system spends $1.7 trillion annually (56% of all spending) on just 5 percent of its patients — and social determinants are at the root.  SDOH isn’t solely about a patient’s lifestyle choices. It’s also the social, economic, and environmental factors among individuals and communities.

According to a report by Deloitte, these factors contribute to about 80% of health outcomes, with clinical care only determining about 20%. Much of what drives the health of our population exists outside of the healthcare system and patient care — yet it puts enormous strain on providers and resources. America spends an estimated $3 trillion dollars on health outcomes annually but the health of its population ranks below other developed countries. This disproportion isn’t just hurting patients, it’s challenging our health system and hurting the bottom line of payers and providers alike

For FQHCs, this can hold particularly true. Many FQHC patients, especially those on Medicaid or Medicare, face uphill battles when it comes to SDOH and the negative impact they can have on health outcomes. The result can mean increased medical and living needs without increased resources to meet them, which result in a greater struggle to ensure positive outcomes. It can sometimes feel like there’s no way to “win” when it comes to these types of high need patients.

Yet addressing  SDOH can have powerful benefits.  When health insurer Humana evaluated food insecurity, they found that people who are food insecure are 50 percent more likely to be diabetic, 60 percent more likely to experience heart failure and 14 percent more likely to have hypertension. By offering SNAP (Supplemental Nutrition Assistance Program) benefits and emergency food boxes, Humana saw the number of days patients were physically or mentally sick drop by half.

SDOH programs hold the potential to reduce cost for care while improving the health of the population. A good SDOH program encompasses preventative and proactive programs. What’s particularly compelling is that solutions to SDOH are often less expensive and more effective than other efforts. Partnerships within the community are can address key issues like transportation, access to healthy food, and other issues. Engaging patients and populations in their own healthcare choices and lifestyles means greater results with less strain on budgets and resources. For FQHCs, this can mean better HEDIS scores, higher incentive payments, and more patients.

We help FQHCs, government programs and providers to develop strategies to drive patient engagement, lower costs and improve outcomes. To learn more, contact us.