SDoH Predictions for 2023
During 2022 I transitioned from leading Social Determinants of Health (SDoH) initiatives at CVS/Aetna, to working with the amazing team and clients of The Focus Group, an HMA Company, on a broader scope of healthcare strategic growth and transformation work, as well as starting a role as Healthcare Advisor to NEXT Ventures. In all these settings, even when it’s not the main goal, SDoH, and how to solve for them, to positively affect health outcomes and quality, nearly always comes to the forefront. Here, then, are my top five* six SDoH predictions for 2023.
SDoH Data “rides equally” with health data – Anyone that’s ever asked me about my work at all won’t be surprised to see this first on my list. If the ultimate goal of SDoH work is to solve for upstream health needs to avert downstream chronic conditions (easiest example: providing fresh foods/steady food supply and food literacy to food insecure individuals), and I believe it is, then data on social needs and social risks is just as important as “traditional” health data. Additionally, with a renewed focus on Health Equity from CMS, payors, providers, and even life sciences companies looking to broaden access to clinical trials, will look for more advanced SDOH data and analytics approaches, such as Socially Determined’s* SocialScape® platform.
Broader Reach for SDoH initiatives: If we’re being honest, due to many inherent infrastructure factors, much of the focus of SDoH initiatives thus far has been concentrated in big cities, making Access to Care an important determinant in and of itself. Some standouts I have my eye on here are Homeward Health, broadly tackling the access issue, and Highmark Health*, which is conducting Community Assessments across its service areas in Pennsylvania, Delaware, West Virginia and New York State (with equal attention to rural areas) specific to solutions for Food Insecurity across each community, using primary (interviews) and secondary research to build analysis, findings and actionable solutions.
Medicaid and CHIP as pathways to Healthy Food Access- look for more states to follow the lead of Massachusetts and their Flexible Services Program for Accountable Care Organizations (ACOs) via new 1115 waivers for Health Related Social Needs (HRSN), with Oregon, Arizona and Arkansas starting similar programs. Also, notable and keeping with the theme from above of expanding access, is the impressive effort of Instacart Health, addressing SNAP (the best, although often underutilized, weapon in addressing Food Security) access and allowing customers to use Temporary Assistance to Needy Families (TANF) funds, as well as a multipronged partnership that will hopefully be the new normal. This pathway may in turn lead to more.
Transportation options grow - almost universally, when we look at the data (See #1. Always!) for factors limiting outcomes, transportation is the #1 barrier. With consumer expectations rising and traditional transportation networks strained, rideshare companies, especially those with offerings targeting the healthcare sector (e.g. Lyft Assisted), will play larger roles in addressing SDoH. Similar to how urgent care centers created more convenient access points for lower acuity patients, rideshare will continue to play a similar role across healthcare. In 2023, you’ll see more lightweight, consumer-oriented healthcare transportation offerings from companies like Lyft which will allow specialized transportation providers to operate at the top of their license, a familiar them in the traditional healthcare world - nudging the industry forward.
New Housing Solutions – No one needs too much of an explanation as to why permanent housing is a significant determinant for health outcomes. While payers have made significant investments in affordable housing and have begun to align investments to health outcomes, these large investments can only scratch the surface for the total need across the country. I’ve been excited to see solutions like Samaritan, which provides memberships to people experiencing homelessness, who set top level goals such as permanent housing, employment, recovery, and more with a care provider and earn bonuses as they take action steps towards goals, while working with an interdisciplinary team for immediate needs. Another impressive new entrant tackling the gap between health and social care, with a focus on housing is FwdSlash, which creates upside, risk-based contracts with Medicaid managed care plans and acquires housing units that allow community housing organizations to provide supportive services to the most vulnerable members resulting in improved health outcomes, cost savings and elimination of homelessness.
Value Based for SDoH – Looking out to the future beyond 2023, I see all of these above themes and examples converging into a Value Based Whole Person care system where payors and providers collaborate for social and traditional health outcomes. In the not-too-distant future, I see a world where “whole person” really has meaning, and we don’t even have to have a separate SDoH discussion. An early entry into this category is the Value Based Care arrangement between Blue Cross Blue Shield of Massachusetts Carbon Health and Firefly Health
*Consulting Client of The Focus Group, an HMA Company