Study supports payers’ efforts to address SDOH using analytics

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A new report is calling for payers, healthcare providers, health systems and others to urgently and immediately address social determinants of health.

The focus on non-medical factors for improving health has received increased attention, and many payers are already adapting approaches to take SDOH into account, says the report by PwC Health Research Institute, a global consulting firm.

“The costs of inaction cannot be escaped,” according to the study, entitled, "Action required: The urgency of addressing social determinants of health.”

“As governments, payers and communities demand more results for the money they are spending, forward-thinking leaders will seize the potential of social determinants of health to right the system so it can produce better outcomes for all,” the report contends.

PwC’s Health Research Institute conducted a global survey in June of 8,000 people in eight territories, along with interviews of healthcare executives and an analysis of more than 20 case studies. Based on its findings, PwC projects that by 2025, many countries will see obesity/overweight rates exceeding 68 percent of their populations.

Despite the severity of the trend, the study found that 57 percent of consumers surveyed have never been approached by their doctors to discuss how social factors could be negatively affecting their health.

Kelly Barnes, PwC's global and US health industries leader, says the benefits of innovative healthcare will essentially be negated if people don't have social support and access to the resources needed to keep them well. "This is not optional; healthcare and government organizations that don't act on social determinants will spend more and more money, only to watch health status decline," she says.

The report calls for a society-wide effort to stall or prevent the advance of chronic disease, particularly those caused by obesity. PwC says data and analytics will be crucial in this effort—to generate the data insights needed to inform decision-making. Predictive analytics will also be needed to address the behaviors of both individuals and populations.

“Many consumers do feel some individual responsibility to make a change, but 47 percent of respondents to [the HRI] survey indicated healthcare providers are not sharing predictions about what healthcare services these patients may need in the future considering their medical history,” PwC says. “Even if people find the motivation, they often lack the information or tools to prevent chronic conditions.”

According to PwC, SDOH strategies must be grounded in the way people live and work. Some 56 percent of those surveyed said they use or plan to use their smartphone to support their heath, but technology can only work if it is embraced and trusted by the community members expected to use it, PwC says.

PwC also emphasizes the need to build the collective will to address SDOH and the importance of developing a framework that enables partners to work toward common goals addressing SDOH.

"Leaders in social determinants of health have built coalitions, harnessed the potential of data and predictive analytics, and identified where early investments in an intervention can have tremendous impact on people's health and lives," Barnes says. "We can't underestimate the transformative effect this action can have not only on health systems and governments, but the healthy life years we can give to more people across the globe."

PwC’s report follows a July study by RAM Technologies, which found that Medicare Advantage plans appear to be at the forefront of pushing SDOH to aid in success under risk-based payment models. However, they can’t succeed without input from others. Providers are an essential link, not only between payers and patients, but between payers and community service organizations that help with SDOH, say the authors of RAM’s report.

The PwC report can be accessed at http://pwc.com/sdoh.

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