A new study found the cost of care to address social needs is significantly more per member per month than federal funding currently provides.
While social determinants of health (SDoH) have become a greater focus area in primary care practices, providers need additional federal funding to implement interventions that address patients’ social needs, according to a recent study published by JAMA Internal Medicine.
In the study, researchers estimate the cost of care to address social needs such as food security, housing, transportation, and care coordination to total around $60 per member per month. Current federal funding only provides $27 per member per month.
"We know that unmet health-related social needs are associated with health disparities and poor clinical outcomes," said senior author of the study Sanjay Basu, M.D., Ph.D., co-founder and head of clinical, Waymark, in a study announcement. "But we've historically lacked an understanding of how much to adjust payments to account for social risk factors. This research fills an important gap for both policymakers and payers evaluating how much additional funding is required to address patients' health-related social needs."
The study used social needs data from the National Center for Health Statistics of 19,225 primary care patients of all ages. The primary care practices included federally qualified health centers (FQHCs), non-FQHCs in urban and high-poverty areas, non-FQHCs in rural and high-poverty areas, as well as practices in lower-poverty areas. While there was disproportionate funding provided to FQHCs, patients at non-FQHCs in high-poverty areas experienced larger funding gaps, noted researchers.
The study also identified enrollment issues in the current federally funded programs. Of the patients with housing needs, though 78 percent were eligible, only 24 percent were enrolled. Additionally, of the patients experiencing food insecurity, 96 percent were eligible for a program, but only 70 percent were enrolled.
Eligibility requirements posed issues for patients with transportation and care coordination needs. Of the patients in need of transportation assistance, only 26 percent were eligible for programs, and of those with care coordination needs, only six percent were eligible for programs.
With federal funding currently covering less than half of the cost required to implement evidence-based interventions to address SDoH combined with the current gaps in federally funded programs, primary care practices need a significant increase in resources to better meet patient needs, urged the researchers.
"Not only are existing programs to address health-related social needs underused, but many people with these needs are not eligible for them," said study co-author Seth A. Berkowitz, M.D., MPH of the University of North Carolina at Chapel Hill, in a statement. "It's not just a question of navigating people into programs that already exist—we need new programs that can address the social context that is making people sick."