Every person deserves a fair and just opportunity to be healthier. No one should remain disadvantaged from achieving their full health potential due to who they are, where they live or any socially defined circumstance. Hospitals and health systems across the nation are working to improve health and access to care by addressing the clinical manifestations of social determinants of health (SDOH) by aligning with their communities to address specific needs, such as food insecurity, and by serving as community anchors to address the structural determinants and root causes of inequities. At Vizient we’re supporting members on their journey to advance health equity and improve community health by providing insights, analytics, education and other actionable solutions. But despite our members’ efforts, closing the gaps in health outcomes also requires the support of policymakers.
The Biden administration’s Executive Order, a recently finalized report by the COVID-19 Health Equity Task Force, and the focus of the U.S. Department of Health and Human Services’ Healthy People 2030 demonstrates the growing attention and desire to address ways to advance health equity. In addition, the bipartisan Social Determinants Accelerator Act, that has been introduced in both the House and Senate establishes a federal interagency council to better leverage existing programs and address the barriers to coordination between health and social services programs. We applaud Sens. Young and Stabenow, and the sponsors of the House version of the legislation for their leadership as the bill would help states and localities develop innovative strategies to address social determinants in their communities.
To help inform future policymaking in Washington, D.C., Vizient recently provided feedback on a Request for Information from the newly formed Congressional Social Determinants of Health Caucus. The Caucus was launched this year to explore opportunities to improve the impact of policies and services that address social determinants of health.
In our comments, Vizient shared feedback on the existing SDOH challenges and ways to improve alignment and transformative actions. Recommendations from Vizient’s letter include:
- Living conditions of populations that experience chronic unmet social needs are arguably the most significant challenges to improving health. The pandemic has exacerbated the negative health impacts caused by social inequities, especially historically marginalized populations such as black, indigenous and people of color, low-income and undocumented populations.
- The lack of consistent and coordinated dedicated financial resources to support investments needed for durable SDOH improvements is an enduring challenge. With strategic funding enhancements, long-term improvements to SDOH can be made to:
- Improve access to primary care and specialist services in underserved communities, which would allow hospitals to support both virtual and direct interactions between patients and primary care providers to connect to tertiary/quaternary care expertise.
- Enable the purchase and maintenance of technology to better coordinate resources and support patients and ensure adequate training and support for troubleshooting and customizations, integration and interoperability. This would support collaboration between state, regional and local organizations with a holistic national response by pooling funding from different sources to achieve aligned goals in addressing SDOH.
- Level the funding playing field by providing seed funding for organizations that receive funding from multiple sources with accountability by developing established targets and opportunities to become self-sustaining.
- Provide incentives and support to enable health systems, health plans and community-based organizations to better share data related to social needs screening and referrals. Such an approach would reduce variability and inconsistent data sharing between products that limit the effectiveness of SDOH interventions for providers, community-based organizations and patients.
- The lack of consistent national SDOH data and definitional standards remains a challenge. Congress and health improvement stakeholders could collaborate through an interagency effort to create national standards and promote interoperable data exchange across the various measurement instruments. In addition, incentivizing the development of webhooks, application programming interfaces and shared privacy standards, could provide opportunities to better integrate multiple platforms, and allow stakeholders to work together more efficiently and boost accountability.
- Vizient also highlighted the positive impact that enacting specific legislation would have in making meaningful improvements in SDOH, including The Social Determinants Accelerator Act of 2021 and the Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act, which would provide positive investments to address and appropriately target social determinants of health at a local level. The CONNECT for Health Act and support for broadband deployments such as the funding included in the recently-passed Infrastructure Investment and Jobs Act in both rural and underserved urban areas would also offer important opportunities to build on recent telehealth advances. Improving maternal mortality is another area where health equity improvements are needed; provisions from the Black Maternal Health Momnibus Act and the Rural Maternal and Obstetric Modernization of Services (MOMS) Act could have an outsized impact on the lives of many minority and rural families.
Improving the health of our communities and identifying and investing in measures to support public health is a clear need. At Vizient, we are making health equity a priority by identifying effective methods to support our members and advocating for policies that bridge gaps between hospital and community needs. Improving health equity is multifaceted, complex and will require resources and creativity to make a significant change. It’s clear that improvement happens faster when we work together. The exceptional results of hospitals working with their community partners are evidence of that. But health equity must be addressed if we’re to improve health care access and delivery across our country. We look forward to working with our members and supporting federal efforts to make meaningful progress toward addressing SDOH.
About the authors:
Shaifali Ray, MHA, directs the strategy and operations of various Vizient member peer-to-peer networks, including Vizient’s Health Equity Network. In this role, Shaifali collaborates with internal and external leaders to develop new programmatic initiatives including tools, resources and educational content focused on helping members address health equity and social determinants of health. She has been with Vizient for more than 11 years in various leadership positions focused on leading member education and initiatives leveraging insights from for Vizient’s ambulatory data products.
Steve Rixen is Vizient’s senior government relations and public policy director. Steve and Vizient’s office of public policy and government relations shape advocacy strategies to effectively communicate with federal officials and lead engagements with federal policymakers on behalf of Vizient and its members. He has been with Vizient in multiple capacities since 2006; and prior to that, Steve worked on Capitol Hill as a professional staffer for U.S. Senator Byron Dorgan.