The National Quality Forum has issued new guidance for state Medicaid programs to improve the collection and use of social determinants of health data.
While social determinants such as economic status and physical environment have significant impacts on health outcomes, according to NQF there has been “little Medicaid-specific guidance for collecting SDOH data and supporting the role of healthcare organizations in addressing social needs.”
To address this, NQF collaborated with the Centers for Medicare and Medicaid Services and convened a panel of experts to identify a framework for Medicaid programs to support the collection of SDOH data and the integration of health and non-health services that can meet social needs.
“Many Medicaid programs have begun to address SDOH through waivers, demonstration projects and service delivery reforms,” states the panel’s recently released report. “However, there is no framework for Medicaid programs seeking to make strategic investments in the collection and use of SDOH data.”
“This report shares important, practical guidance for healthcare and community stakeholders to work together toward a more holistic approach to improving the health of our nation’s most vulnerable populations,” said Romana Hasnain-Wynia, chair of the NQF panel and chief research officer at Denver Health.
The panel specifically focused on food insecurity and housing instability, which lead to lower health outcomes and are seen as key areas for Medicaid programs to support data collection efforts in the short term.
Among the panel’s recommendations for Medicaid programs are that they:
- Increase information sharing between government agencies.
- Harmonize tools that assess social needs that impact health to ensure that they collect and document the same type of information.
- Create standards for inputting and extracting social needs data from electronic health records
When it comes to EHRs, the panel called for consensus on the inputs as well as the outputs for social needs data in these systems.
“Standardizing these data fields will enable better sharing of information between health and non-health providers and programs,” contends the panel. “For example, ICD-10 uses Z codes (similar to the V and E codes used in ICD-9) to capture information like homelessness and lack of adequate food and safe drinking water. However, standards cannot exclusively focus on diagnostic codes, but need to also include coding standards for screening and treatment activities related to SDOH like food insecurity and housing instability.”
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