SDOH interventions in primary care cost $60 per member each month: Study

The average cost of addressing social determinants of health is more than double what existing federal programs will cover, according to a study published May 30 in JAMA Internal Medicine.

"We've historically lacked an understanding of how much to adjust payments to account for social risk factors," Sanjay Basu, MD, PhD, a senior author on the study and co-founder and head of clinical at Waymark, said. "This research fills an important gap for both policymakers and payers evaluating how much additional funding is required to address patients' health-related social needs." 

The study analyzed data from more than 19,000 youth and adult patients who were seen at a primary care practice from 2015 to 2018. Primary care practices were categorized as federally qualified health centers, non-FQHC urban practices in high-poverty areas, non-FQHC rural practices in high-poverty areas and practices in lower-poverty areas. The analysis took place between March and December 2022.

Seven key takeaways:

  1. The cost of providing evidence-based interventions for food, housing, transportation and care coordination needs averaged $60 per person per month, of which $27 was federally funded. 

  2. The cost of universal screening for social needs was $5 per person per month.

  3. Among people with food needs, 96 percent were eligible for federally funded programs, but only 70 percent were enrolled.

  4. Among people with housing needs, 78 percent were eligible for federally funded programs, but only 24 percent were enrolled.

  5. Among people with transportation needs, only 26 percent were eligible for federally funded programs.  

  6. Among people with care coordination needs, only 6 percent were eligible for federally funded programs.

  7. Disproportionate funding was available for individuals who went to FQHCs, but those who were seen at non-FQHC practices in high-poverty areas had larger funding gaps.

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