A majority of consumers have at least one social determinant of health (SDOH) challenge that could impact their care, according to a survey from medical billing service Waystar. SDOH, which are the social and economic conditions among individuals, can negatively impact health status for some patients through lack of transportation to care appointments, lack of healthy food and housing insecurity.
Over the last several years, SDOH have come more into focus as the healthcare system targets treating the whole patient. Medicare Advantage has already expanded supplemental benefits to address some SDOH, and Medicaid could even pay for housing in the future, HHS Secretary Alex Azar recently suggested.
Consumers with SDOH stress tended to rate their health status much lower than the rest of the population, according to the survey. They are also more likely to suffer from one or more chronic conditions, and more than 20 percent report high SDOH risk, even in the healthiest categories.
Waystar surveyed 500 consumers for its report.
SDOH challenges were common, according to the report, with 68 percent having at least some level of challenge. More than half––52 percent––have moderate to high SDOH risk in at least one category.
The most common SDOH issues reported across all payer classes included financial insecurity and social isolation. Food insecurity was the least common issue among those who were commercially insured, while health literacy was the lowest self-reported issue among the Medicare and Medicaid population.
One of the biggest concerns for healthcare providers is missed appointments, which are costly and can lead to more extreme health instances in patients, particularly those with chronic conditions. Among consumers in the high risk category for SDOH, 23 percent indicated their issues caused them to miss at least one healthcare appointment per month.
Consumers with government-sponsored insurance had greater SDOH stress compared to those with commercial insurance, according to the survey. Among individuals with government-sponsored insurance, 33 percent were high risk, compared to 21 percent of the commercial insurance population.
Despite the risks associated with SDOH, few providers communicate with patients about their challenges and the related stress that could impact health status.
“This effort is far from universal due to issues of response and perception bias as well as resource limitations,” the report reads.
Just 22 percent of respondents with SDOH stress said they’ve discussed these issues with their physicians.
Even when organizations do offer assistance with SDOH, patients don’t always use it. The vast majority of patients offered programs and services to address SDOH challenges have moderate or high risk––83 percent––but 46 percent declined to accept assistance, according to the study.
"Organizations are still undervaluing processes within their clinical care to determine these challenges and find support to help improve risk factors for a better, longer-term health outcome for the patient," Matt Hawkins, CEO of Waystar, said in a statement. "If we are going to take the right steps to promote value-based healthcare, we have to start by addressing the social needs of patients. This starts with talking with care teams on the front lines to better understand the learning gap in understanding SDOH needs of their patients."
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."