RISE looks at recent headlines concerning social determinants of health (SDoH).
SDoH associated with increased risk of suicide in veterans
Social needs have a significant impact on a veteran’s risk of suicide, according to a recent study published by JAMA Network Open. Researchers conducted a nested case-control study of veterans who received care under the U.S. Veterans Health Administration from October 1, 2010, to September 30, 2015.
Using a natural language processing (NLP) system to extract SDoH from the veteran’s electronic health records, the researchers found nine SDoH were associated with an increased risk of suicide among U.S. veterans. The SDoH identified included social isolation, job or financial problems, housing instability, legal problems, violence, barriers to care, transition of care, food insecurity, and nonspecific psychosocial needs.
Of the 6,122,785 veterans included in the study, 8,821 committed suicide. The three SDoH researchers found had the largest effect were legal problems, violence, and nonspecific psychosocial needs.
The research team urged for continued use of the NLP tool in studies to use unstructured SDoH data that can identify additional at-risk patients. “Our results also indicate that integrating NLP-based SDoH can benefit similar analyses by identifying more patients at risk,” they wrote. “We strongly believe that analyzing all available SDoH information, including those contained in clinical notes, can help develop a better system for risk assessment and suicide prevention.”
HHS announces $120M in funding for community behavioral health clinics
The U.S. Department of Health and Human Services (HHS), through Substance Abuse and Mental Health Services Administration (SAMHSA), has announced two grant funding opportunities, totaling over $120 million, available for Certified Community Behavioral Health Clinics (CCBHC). CCBHCs were created to provide 24/7 mental health and substance use crisis services and treatments across the U.S.
The latest funding aims to support CCBHCs with expansion opportunities such as new program implementation as well as existing center enhancements.
“CCBHCs are transforming behavioral health systems in this country, and we know that the model of care works,” said Miriam Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA, in a statement. “Data show in the first six months of receiving care, CCBHCs decrease homelessness, decrease the amount of time spent in correctional facilities, decrease the time spent in emergency rooms for behavioral health issues, decrease inpatient hospitalization for mental health treatment, and decrease the use of illegal substances.”
Study: Patients’ SDoH influence extent of personalized care
Integrating patients’ SDoH into electronic health records (EHR) can lead to more personalized care, according to a recent clinician study published by Annals of Family Medicine. To better understand the extent to which patients’ SDoH impact clinicians’ care delivery and decision-making, researchers analyzed EHR survey data from clinician-patient interactions.
Their findings include:
- SDoH influenced 35 percent of the surveyed encounters
- The most common sources of information on patients’ SDoH included conversations with patients (76 percent), prior knowledge (64 percent), and the EHR (46 percent)
- SDoH were much more likely to influence care among male and non-English-speaking patients as well as patients with discrete SDoH screening data in their EHR
“Electronic health records present an opportunity to support clinicians integrating information about patients’ social and economic circumstances into care planning,” wrote researchers. “Study findings suggest that SDoH information from standardized screening documented in the EHR, combined with patient-clinician conversations, may enable social risk-adjusted care.”
Health care organizations call on CMS to implement hybrid primary care payment model in MSSP that addresses social needs
More than 25 health care organizations have signed a letter calling on the Centers for Medicare &Medicaid Services (CMS) to establish a hybrid primary care payment option in the Medicare Shared Savings Program (MSSP) to further value-based care.
“CMS’ beneficiaries and the larger American public are grappling with pressing health needs. All communities–especially those that are disadvantaged or underserved–face lapses in preventive care, unmanaged chronic conditions, skyrocketing mental health and substance use issues, and emerging health challenges associated with long COVID,” stated the letter. “Time is of the essence to implement multiple strategies to strengthen the primary care platform to get to better health.”
In the letter, the organizations endorse six principles of the proposed model, with the first principle prioritizing equity. The organizations propose the hybrid model reflect beneficiaries’ social risk as well as provide support to address their SDoH. The equity-focused principle also requests the payment option include incentives for practices to serve vulnerable and at-risk populations.
To read the full letter and additional principles included, click here.