Perspectives on Social Determinants of Health Session One: SDOH and Primary Care

Background Many studies suggest that more health care costs are driven by social factors --commonly referred to as Social Determinants of Health or SDOH -- than by medical care itself. It's both intuitively obvious and supported by evidence that inadequate nutrition, housing, and transportation make it difficult or impossible for some people to follow healthy diets, manage chronic conditions, engage with primary care, and avoid unnecessary emergency room and inpatient utilization. Despite years of pronouncements that health care spending is unsustainable, it continues to grow. As the health care system adopts "value-based care," health care organizations (HCOs) have a powerful incentive to improve the "upstream" social factors that affect "downstream" care – particularly when that care includes expensive avoidable emergency room and inpatient hospital utilization. The industry has embraced the proposition that addressing SDOH might help control cost and utilization, as well as improve patients' quality of life. Health plans, health systems, hospitals, and other HCOs are actively creating and participating in initiatives to address SDOH. While the link between inadequate nutrition, housing, or transportation and suboptimal health and use of the health care system is obvious, it is much less clear how to address the social barriers to health. This series of study groups will explore foundational challenges, and how successful SDOH initiatives address them, from a variety of perspectives. Future sessions will cover Housing and health integration Hospital investments in SDOH Human-centered design in SDOH This session will be a discussion with Julita Mir, MD, Chief Medical Officer, Community Care Cooperative (Medicaid ACO) and Rushika Fernandopulle, CEO and co-founder, Iora Health. Our topics will be Introduction to SDOH Patient stories The SDOH challenges that primary care providers encounter Challenges and opportunities for primary care to address SDOH Primary care's role in addressing SDOH, vs. other sectors How reimbursement helps or hinders primary care's ability to improve SDOH, individually and globally.