Analysis

Addressing social determinants of health in hospitals

How are hospitals and health systems investing in social needs?

Our survey of 300 hospitals and health systems explores how factors outside the health care system—the social determinants of health—affect patients’ long-term well-being and what health care organizations can do to address these challenges.

Improving long-term health outcomes

Health care stakeholders have long recognized that factors outside the health care system—the social determinants of health—influence an individual’s health and well-being. Many hospitals and health systems are working to navigate the challenges of effectively linking community and clinical services to improve health outcomes in the long term.

The Deloitte Center for Health Solutions conducted a nationally representative online survey of about 300 hospitals and health systems to identify their current health-related social needs and activities and investments and their potential future efforts. To better understand how hospitals and health systems may be operating in the larger health care ecosystem and the challenges they face, we also interviewed representatives of hospitals, health plans, and nonprofit community organizations.

Our research shows that hospitals and health systems are investing in health-related social needs, and that leadership support is high: 80 percent of hospital respondents reported that leadership is committed to establishing and developing processes to systematically address social needs as part of clinical care. However, our findings also indicate that much activity is still ad hoc (defined in our survey as occasional and only reaching some of the target population), and gaps remain in connecting initiatives that improve health outcomes or reduce costs.

Some of our key findings include:

  • Hospitals are screening patients and intervening around social needs, though some activity is fragmented and ad hoc
  • The health care system’s shift toward value-based care may spur more investment and activity around addressing social needs
  • Hospital investments vary and sustainable funding may be a challenge

The health care stakeholders we interviewed think that addressing health-related social needs is the “right thing to do” and expect that alignment with value-based care will likely continue to spur partnerships and innovative solutions.

The future of addressing health-related social needs

​Data on some of the social needs programs and partnerships around the country indicate that some hospitals are having early successes with some initiatives in improving health outcomes and the patient experience. Through our research, we hope to establish baseline metrics against which health care organizations can measure their efforts as they tackle this complex issue in the coming years and provide recommendations for moving forward in the short and long term.

Many hospitals and health systems are beginning to engage in activities around addressing health-related social needs and are starting to develop their capabilities and invest staff and resources in this area. However, the ability to measure results from their initiatives is likely necessary to advance the goals of improving health outcomes and reducing costs and may require stakeholders to:

  • Break down siloes and consolidate resources
  • Continue to move toward value-based models to further align social needs and clinical care
  • Identify strategies to improve their ability to track health and cost outcomes
  • Share leading practices and data on other organizations’ activities and strategies to direct investments

Addressing health-related social needs will likely require an ecosystem approach—with hospitals and health systems working with health plans; federal, state, and local governments; community organizations; and local businesses, employers, and families—to implement initiatives that impact health and quality of life. Opportunities to share leading practices, integrate data to help identify needs and measure outcomes, and collaborate on community initiatives will likely be critical to help stakeholders make the most of their efforts.

Download the full report to learn more.

Health care organizations are likely to want to see ROI from addressing social needs, in terms of improved health outcomes, reduced costs, or both.

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