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:
- 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.
- The cost of universal screening for social needs was $5 per person per month.
- Among people with food needs, 96 percent were eligible for federally funded programs, but only 70 percent were enrolled.
- Among people with housing needs, 78 percent were eligible for federally funded programs, but only 24 percent were enrolled.
- Among people with transportation needs, only 26 percent were eligible for federally funded programs.
- Among people with care coordination needs, only 6 percent were eligible for federally funded programs.
- 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.