Deloitte Study: How Are Hospitals and Health Systems Addressing the Social Determinants of Health?

NEW YORK, July 20, 2017 /PRNewswire/ -- A new health care survey "Social Determinants of Health: How are hospitals and health systems investing in and addressing social needs?" from the Deloitte Center for Health Solutions revealed that the trend toward value-based care is providing an opportunity for hospitals to better align their clinical care with health-related social needs. Environmental and social factors that impact health—including the environments in which people are born, grow, live, work and age— determine 80 percent of health outcomes, yet they are often poorly understood or integrated into treatment protocol.

The nationally representative survey of 284 U.S. hospitals found that while health system goals are shifting toward social needs and clinical care alignment, hospitals are still learning how to reap the benefits of coordinated care and evolving payment models.

In this report, Deloitte set out to understand how hospitals and health systems are addressing the social determinants of health (SDoH). A few key findings:

• Eighty percent of respondents report that leadership is committed to establishing and developing processes to systematically address social needs as part of clinical care.
• Hospitals are primarily screening their inpatient (90 percent) and high-utilizer populations (83 percent) for social needs. Fewer hospitals (69 percent) are screening more broadly in their communities.
• Almost 40 percent of hospitals report having no current capabilities to measure the outcomes of their activities, although most hospitals report that demonstrating improved health and cost outcomes, and improved patient experience, are important goals underlying their strategies to address social needs. However, hospitals that are further along in the journey to value-based care report that they are more likely to measure more aspects of their social needs activities.

"I think hospitals and other providers see clearly the connection between social determinants and health care. They see it every day. And from this study we see that they are taking steps to do something to help their patients connect to programs that can address their needs," said Sarah Thomas, managing director, Deloitte Services LP and leader of Deloitte Center for Health Solutions. "What we still need, though, is a better understanding of what programs work best and for which patients."

Funding and structural issues also emerged as challenges for many hospitals. Most hospitals surveyed, 72 percent, do not have dedicated funds for all of the populations they want to target and report that finding sustainable funding sources may be a challenge. 

"The research really highlights the gap between desire and ability in this industry right now. It's striking to see how widely health care leaders embrace the mission of addressing social needs, with an almost palpable frustration around how best to take action," said Josh Lee, principal, Deloitte Consulting LLP and co-author of the report.

Health care stakeholders should consider the following path forward:   

• Adopt a consistent definition and metrics around addressing SDoH. The research revealed a wide discrepancy in understanding and corresponding measurement approaches around SDoH. Common definitions and data sets will help accelerate the industry's ability to test, learn and share best approaches.
• Scale what is working. On the bright side, the research identified many programs that seem to be working. Leading health care organizations should actively pursue ways to introduce effective models into their organizations and assist effective programs to scale their impact.
• Break down silos and consolidate resources. This may help to better achieve scale and avoid duplicating efforts and burdening staff and patients with inefficient practices.
• Continue movement toward value-based care models to further align social needs and clinical care. Many interviewees said that regardless of the direction of federal and state funding in the coming years, the move toward value-based care is expected to further advance the ability to address social needs.
• Identify strategies to improve their ability to track health and cost outcomes. Hospitals are using a mix of data to address social needs and could benefit from data in other parts of the system.
• Share leading practices and data on other organizations' activities and strategies to direct investments. Stakeholders should look to existing settings for information sharing such as research forums or venues where multiple stakeholders in the local or business community can share ideas.

Conducted by The Deloitte Center for Health Solutions, the Social Determinants of Health study was a nationally representative online survey of 284 hospitals and health systems to identify the activities and level of maturity in their health-related social needs investments, and their potential future efforts to address these needs. Survey respondents represented hospital leadership and staff responsible for social needs initiatives. The survey was conducted in March and April 2017. Health Leads, a national health care organization that connects low-income patients with the basic resources they need to be healthy, and other external advisors helped in the development of the survey instrument.

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