In emerging health care delivery models, social determinants of health (SDOH) screening tools have been prioritized in emerging health care delivery models that aim to change traditional care delivery and reimbursement for broader support services. However, with changes in SDOH, usually accompanied by changes in the priorities of the new federal government, the changes in SDOH are already changing.
At present, the Trump administration has revoked the Biden administration’s guidance on the SDOH of the Medicaid and Children’s Health Insurance Program (CHIP) and the Health-Related Social Needs (HRSN) Services (CHIP), saying that it will determine the approval of service requests for HRSN/SDOH based on a state-by-state basis. Although previous guidelines on HRSN/SDOH screening remain unchanged, especially for inpatient HRSN screening, additional time is needed to assess the overall impact of the government on HRSN/SDOH screening and services.
Given these new parameters, it is important to ensure that SDOH filtering is more than just check box operations. After these screenings, healthcare leaders must develop meaningful plans – follow shared sharing among patients and successfully address inequality for better health. What are the broader questions? What happens when a healthcare organization lacks a standardized approach? What is the new method like?
Current screening challenges
Tools such as AHC screening are developed to address the critical gap between clinical care and community services in our healthcare system, and it is heading towards standardization but not consistently used. Screening is considered a best practice but has not been adopted uniformly by providers and organizations throughout care. There are several different reasons today.
First, many healthcare organizations are not suitable by default for tools that meet requirements without evaluating their consistency with specific needs. Clinicians who provide direct patient care have been extended. Expect them to be able to process other data exchanges or limited data exchanges outside of the health system to expect them to accept other manual data input, not to mention requiring them to access different systems to screen or view results, because filtering tools are not usually integrated into the technology platform and EHRS is used to the provider’s use.
Furthermore, when the collected data is not used, it not only makes people identified challenges unresolved – widens the gap in care – but also erodes the trust of patients because they share very personal information and expect it to inform their care. Patients’ willingness to participate in screening and stay engaged is built around trust. A study published in the American Journal of Managed Care said that between April 2020 and January 2024, patient trust fell by 31.4%, making the implementation of new policies supporting clinical relationships more priority.
Screening is not enough
As we know, identifying challenges such as food insecurity or housing instability does not solve people’s lives. Yes, realizing them is a benefit (“you can’t manage what you can’t measure”); however, many clinicians lack the resources and roadmap to effectively address these issues. This is a broader question. The truth is that filtering tools are artifacts. Their value depends on how they are used, what happens afterwards, and the systems that support them.
As a department, we need to go beyond the measurement screening process to measure results. The SDOH challenges are rooted in general inequality in areas such as food accessibility, education and housing. No one would say, “Because I was shown, I was able to support my family.” A step after screening was totally important, and payers and providers had the opportunity to build better systems here. Referral alone is not enough; we need to connect individuals to actionable pathways and then measure the impact of these connections. The measurement takes time, but it is important. Filtering is just the starting point, not the finishing line.
New SDOH approach
There is no doubt that SDOH screening plays an important role in providing health care to our communities, understanding that the current screening process is not a standard but a best practice yet, and tested in the silent phase of our industry. We can start by better understanding the health needs of the community by better improving the way data collection and service delivery. However, the provider’s role in this process cannot be discounted.
By providing measurements without providing solutions, we will perpetuate responsiveness and create an injustice system – for patients who have extended thinly and who may screen in a casual manner without subsequent direct responses to meet their needs. Providers need to be equipped with resources and time to meaningfully follow patients who share SDOH needs, and then be able to synthesize the data they receive and see better outcomes that it applies to patients.
SDOH filtering is a key tool, but they are only the first step. Healthcare systems must collectively face the challenges of addressing the root causes of inequality and create meaningful support for patients so that they can actually make a difference.
Image source: Big Stocks
Danielle Carter is CEO of Intrepid Ascent with over 15 years of experience in global public health, health care and community-based public health programs. Since joining the Brave Team six years ago, she has played a role in guiding the company’s growth, including deepening its impact on Medicaid and community health transformation, services around the needs and experiences of the people they serve and adopting quality improvement and people-centered design approaches. With Carter’s leadership, Intrepid has enhanced its ability to implement programs at the intersection of healthcare and social services, leveraging technology to connect partners and transform communities.
This article passed Mixed Influencer Programs. Anyone can post opinions on MedCity News’ healthcare business and innovation through MedCity Remacence. Click here to learn how.
