The healthcare and treatment industry are leaning towards a shift in its approach towards patient care. The focus is shifting from merely treating behaviors to understanding the root causes that impact health outcomes. One such factor gaining substantial recognition is the Social Determinants of Health (SDOH). These will gain more momentum and become directly tied to reimbursement.
SDOH are conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels source. There are direct correlations between a query of a person’s social determinants and the predictability of their success/compliance with treatment recommendations.
With the introduction of 42 new ICD-10-CM diagnosis codes by the CDC for reporting certain SDOH, it's clear that capturing these determinants is becoming increasingly critical in healthcare. Furthermore, a facility’s ability to identify social determinants is beginning to impact reimbursement such that it is not only good care, but also directly tied to some rates.
Identifying SDOH not only provides a deeper understanding of patient populations, but by virtue of understanding, we are better able to create an effective treatment plan. For example, documenting a patient's transportation issues should alert the treatment team to challenges the patient might face as we set up their aftercare. They tell us that they don’t have a ride and then we wonder why they aren’t attending PHP/IOP. You want to know why your step-down rates are so low? Look at the scores for the SDOH from the population that “agrees” to come to treatment and then never shows up, why were you surprised?
In addiction and behavioral health treatment, addressing SDOH is equally crucial. Factors like food, transportation, and safety can contribute to health inequities and impact recovery rates. By embedding SDOH into our culture and clinical operations, we can better understand and address these issues, leading to improved outcomes. For the record, SDOH measures are not just for lower socio-economic groups, they are relative set of measures that must be seen through the lens of each financial class and demographic. Someone from each socio-economic group might site transportation issues and for different reasons (e.g., one doesn’t have a car and the other is too impaired to drive, etc.).
It's time for us to move beyond traditional patient care models and embrace a broader perspective that includes social determinants. By doing so, we can deliver more empathetic, effective, and comprehensive care to our patients.
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