SOCIAL DETERMINANTS AND SOCIAL NEEDS

Over the last thirty years, consistent and compelling evidence has documented strong associations between socio‐economic risk factors and health outcomes. This has led to a growing number of payment and practice innovations across the health care sector related to identifying and addressing patient social risks alongside more traditional biomedical care. In 2018, the National Academies of Sciences, Engineering, and Medicine (NASEM) convened a one‐year national expert committee charged with examining the potential for integrating social care and health care services to achieve better health outcomes and to help overcome major challenges facing the U.S. health care system. Over the course of 2018‐2019, the NASEM Consensus Study Committee conducted multiple literature reviews and held several open meetings to gather evidence related to the charge. Though much of the innovation in this field relates to primary care, evidence was also reviewed from other health disciplines. The final committee report highlights five health care sector approaches to providing social care and to strengthening the social resources landscape, including increasing awareness about patients’ social risks; making adjustments to clinical care based on social needs; providing assistance to more consistently and effectively link patients with community‐based social resources; better aligning health care resources with community social care activities; and ensuring the health care system is involved in advocacy activities to strengthen social resources. The report also explores the workforce demands of social and medical care integration; health information and technology needs of social and medical care integration; payment models that can support integration; and other major barriers to integration. The NASEM report articulates concrete approaches for the health care sector to address social needs as one part of comprehensive strategies to improve patient and population health and health equity. Key policy recommendations based on the report findings include designing a health care system to accommodate the five approaches; recruiting and training a workforce able to provide social care; developing financing mechanisms that support integrated care activities; improving an interoperable digital infrastructure across health and social care sectors; and funding, conducting, and translating research on effectiveness and implementation of integrated care activities. 40 funders convened to support the NASEM consensus study.