RISE looks at recent headlines concerning social determinants of health (SDoH).

Gallup poll looks at mental health ratings amid COVID-19 pandemic

The number of Americans who rate their mental health as “excellent” is the lowest it’s been in 21 years amid the pandemic, according to a recent Gallup poll. The poll, conducted from Nov. 1-16, found the “excellent” mental health rating has remained at 34 percent since last year. Prior to the pandemic, the rating had consistently reached 42 percent or higher from 2001 to 2019.

Other key findings from the poll include:

  • An additional 47 percent of Americans rated their mental health as “good”
  • Though the poll saw a score of 81 percent for combined “excellent” or “good” ratings, it is still below the pre-pandemic level of 85 percent
  • Another 15 percent of Americans rated their mental health as “only fair” and 4 percent as “poor”
  • The highest mental health ratings were found among men, frequent churchgoers, Republicans, and those with an annual household income of $100,000 or more
  • Americans continue to rate their physical health higher than their mental health

CMS encourages hospitals to implement patient safety practices in maternity care

The Centers for Medicare & Medicaid Services (CMS) announced last week steps it will take to ensure equitable, comprehensive maternity care for pregnant and postpartum individuals. Since Vice President Kamala Harris’ Call to Action to Reduce Maternal Mortality and Morbidity on Dec. 7, CMS is encouraging hospitals to implement patient safety best practices to improve maternity care and health outcomes.

“There is no greater priority than ensuring pregnant and postpartum individuals receive the best possible care, and the Biden-Harris Administration is committed to working with the provider community and beyond to make that happen,” said CMS Administrator Chiquita Brooks-LaSure in the statement. “Too many individuals  ̶  a disproportionate share of them people of color ̶ experience unnecessary pregnancy-related complications and deaths. We must do everything we can to change that.”

The RISE Summit on Social Determinants of Health

Among its recommendations, CMS encourages hospitals to review their policies and procedures and incorporate best practices where appropriate. One of the recommended best practices CMS encourages hospitals to consider implementing includes “maternal safety bundles,” an evidence-based practice to improve patient safety and quality of care that has been found to be successful in improved outcomes with obstetric hemorrhage, severe hypertension in pregnancy, and non-medically indicated Cesarean deliveries. The bundles have also been linked to closing the racial disparity gap in some perinatal outcomes.

The latest steps from CMS come after the agency adopted a new quality measure for the Hospital Inpatient Quality Reporting Program in October that asks hospitals to attest to whether they participate in a statewide or national perinatal quality improvement collaborative, and whether they have implemented patient safety practices or bundles to improve maternal outcomes.

Z code utilization as a tool to improve health outcomes

Z code utilization to capture SDoH factors among patients present an opportunity to assist stakeholders in addressing social needs that impact health outcomes and health care costs, according to a recent analysis conducted by Avalere.

“Capturing SDOH factors for patients occurs through multiple channels, and challenges in standardization of SDOH data collection and usage have posed the need for a more streamlined data collection method,” wrote the Avalere team. “One tool that can be leveraged to capture and track non-clinical needs of patient populations is the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes.”

The non-clinical needs which influence health outcomes—the SDoH factors collectively referred to as Z codes— include factors related to safe housing, education, income, loneliness, family circumstances, and more.

Over the last six years, the Centers for Medicare & Medicaid Services (CMS) has added and revised 169 ICD-10-CM Z codes to improve patient SDoH data collection. The FY 2022 update includes 19 new codes, including codes which indicate less than a high school diploma, inadequate drinking water, homelessness, lack of food, and other problems related to housing and economic circumstances.

Further Z code utilization would help stakeholders in three key areas, noted Avalere:

  1. Identify and address the most prevalent social risk factors among a specific population
  2. Understand and address issues related to adherence in receiving care
  3. Initiate and track referrals to social services