NASEM Report Urges Consideration of Social Needs in Health Delivery to Improve Outcomes, Reduce Disparities

In a new report released by the National Academies of Sciences, Engineering, and Medicine (NASEM), finds five overarching goals and associated recommendations for health systems, government agencies, and related entities should implement to better integrate patients’ social needs into health care delivery. The report, Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health,examines the need to integrate social care with health care, largely finding that the move toward paying care providers based on health outcomes (rather than visits or services) and an increasing recognition that the social determinants of health have a profound impact on an individual’s physical and mental health have fueled the need to broaden the focus of health services.

The challenge in the U.S. is determining how social services – including home help for the elderly, rent subsidies, child allowances and credits, childcare support, job training, and disability benefits – are uniformly defined and financed in the health care space, according to the report. The report details a series of recommendations:

• Better integrate social care into health care delivery. Health care organizations are recommended to, among other actions, make an organizational commitment to addressing health-related social needs, identify the most effective ways to assess and document social needs, and include social care providers as an integral part of health care teams.
• Support and train an engaged, integrated care workforce. Currently, certain federal, state, and institutional barriers limit adequate payment of social care workers and their ability to work to the full extent of their education and training. Workforce development efforts should aim to create standards for the reimbursement of social care by public and private payers, test for knowledge of social determinants of health in licensure exams, and adopt curricula that prepare students of social work to use technology, data collection, and payment methods.
• Develop an infrastructure for data sharing between health and social care. The report calls for a national vision and defined technology standards for integrating health care and social care data, similar to the standards underpinning the adoption of electronic health records.
• Finance the integration of health care and social care. Specifically, the report calls on the U.S. Centers for Medicare and Medicaid Services (CMS) to define which aspects of social care Medicaid can cover, incentivize health organizations and managed care programs to collaborate with community-based health and social services, and coordinate the coverage benefits of dually eligible and high-need Medicare and Medicaid populations.

The report calls for more formalized and robust evaluations of the effectiveness of integrating social care needs into health care delivery to provide health officials and stakeholders with concrete examples of effective integration of social care and health care. The full report is available here.