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Hospitals spent on social determinant programs

Hospitals spent on social determinant programs

Investment announcements study found that 57 health systems invested at least $2.5 billion in social determinants of health over a two-year period. Healthcare systems are making notable investments in programs that address social determinants of health, such as housing, employment, and food security, according to a new study published in Health Affairs.

In analysis of public announcements of new social determinants of health programs operated by US health systems from Jan. 1, 2017, to Nov. 30, 2019, researchers from New York University uncovered at least a $2.5 billion in investments from 57 health systems that collectively included 917 hospitals. The health system funds were allocated to 78 unique programs launched during that time.

According to study, “Historically, hospitals have tended to provide community benefit through uncompensated or subsidized care rather than through investment in activities not directly related to health,” But now, health systems have found a new strategy to improve outcomes and lower costs outside the walls of their organization

Commonly-cited statistics show that social determinants of health can affect between 80 to 90 percent of patient outcomes. In an effort to improve outcomes while reducing costs, the healthcare industry including federal agencies has made a conscious effort to develop programs that address one or more social determinants of health.

Social determinants of health investments may have also been concentrated among bigger health systems because of the “complexity of making tangible commitments,” researchers stated. These organizations may have more capacity to launch programs that address social determinants of health than non-investing systems, they added.

But many of these programs are still in their infancy, the analysis indicated. Social determinants of health investments in simpler interventions (i.e., programs that address transportation and other social determinants other than housing) were typically pilot programs that were initially offered to a handful of patients. As an example, researchers pointed to Henry Ford Health System’s partnership with Lyft and the start-up SPLT, which offered rides to 25 patients who had a history of missing dialysis center appointments.

Other more complex programs, such as those that address housing security, were typically operated in conjunction with state of local agencies, community development financial institutions, or local community groups.

Additionally, most health systems did not specify an investment commitment duration. Of the 31 systems that did, the average time was 5.4 years. Only two programs involved health system commitments of annual expenditures for the foreseeable future, researchers stated.

According to Health Affairs, their results quantified the scope and scale of investments in upstream social determinants by health systems at a substantially more granular level than has previously been available. However, there were some limitations. First, health systems may have made investments without publicly announcing them, though we suspect that any such investments would likely have been small since investment leads to public relations benefits. Second, we could have missed some announcements if they were not captured by our search strategy, although we confirmed the accuracy of that strategy by doing other, more specific searches—such as for the terms housing and hospital and program.

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World Health Organization. Social determinants of health: what are social determinants of health?

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