H&HN Daily

Prescribing a Whole Lot More than Medicine

06.17.14 by Bill Santamour H&HN Managing Editor

Providers have new reasons to address the social and economic factors that affect patient health

Certain ideas seem so obvious you have to wonder why it takes them so long to gain traction in the public's mind. That struck me last week as I was going through a pile of reports exhorting hospitals and other health care providers to address the nonmedical needs of their populations.

“Extensive research documents the impact of social factors such as income, educational attainment and access to food and housing, and employment status on the health and longevity of Americans, particularly lower-income populations,” states a Commonwealth Fund report released in May.

Your first reaction may be, “Well, duh.” Common sense tells us that maintaining health is not just about what happens in the hospital or physician’s office.
Your second reaction, though, should be to read the report, which cites “changes in the health care landscape that are catapulting social determinants of health into an on-the-ground reality for providers.” If something’s being catapulted in your direction, you'd better be prepared to intercept it or get out of the way.

Among those landscape changes are capitated, global and bundled payments, shared savings arrangements and penalties for hospital readmissions, all of which “give providers economic incentives to incorporate social interventions into their approach to care.” Doing so can affect patient and employee satisfaction; HCAHPS and quality scores; and outcomes of care. Not to mention, the bottom line.

As I note in my May Health Matters column in Hospitals & Health Networks, most hospital executives, their staffs and board members are already aware of the growing imperative to understand both the medical and nonmedical needs of their communities. A lot of hospitals employ social workers and community outreach staff to help patients with everything from transportation to identifying which local agencies could help with food, housing, legal issues, job hunting, education and other needs. However, the growing emphasis on population health management will intensify the push toward a truly holistic approach — something the behavioral health arena has long embraced and which is known as “wraparound care.”

The good news is that more nonprofit organizations are popping up to aid providers. One cited by the Commonwealth Fund, called Health Leads, currently operates in six cities. Here’s how it describes itself: “Health Leads enables doctors and other health care providers to ‘prescribe’ basic resources like food and heat just as they do medication. We recruit and train college students to ‘fill’ these prescriptions by working side by side with patients to connect them with the basic resources they need to be healthy.”
By partnering with organizations like that, hospitals are building a continuum of wraparound care that will boost wellness and care outcomes, cut readmissions and help individuals and communities thrive.