Most people assume that the care delivered inside hospitals, clinics and physician offices accounts for the entirety of health outcomes, but that’s far from the case. In reality, about 80% of a patient’s health and treatment results rely on the social determinants of health.
The U.S. Centers for Disease Control and Prevention defines social determinants of health as “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.” The Centers for Medicare & Medicaid Services, or CMS, goes further, specifically highlighting housing, transportation, education and social isolation as social determinants.
These and other factors have a direct influence on health outcomes. And because so many medical facilities are transitioning to value-based care models, it’s important to understand how they affect your bottom line. For example, in 2018, CMS launched its Hospital Readmissions Reduction Program.
This initiative encourages hospitals to improve care coordination and communication to better engage patients and caregivers in discharge plans with the goal of reducing readmissions. If a patient is readmitted to a hospital within 30 days of their original discharge, Medicare only reimburses a fraction of the costs of treatment. While this might sound harsh, it’s with the goal of improving patient health.
If you operate a clinic, hospital or health system, it’s important to understand the social determinants of health and the effect they have on patient outcomes. When you understand everything about a patient’s life, including the neighborhood they live in, the type of food they eat and their ability to access various services, such as affordable housing or addiction counseling, it’s easier to provide them with the care they need.
How do the social determinants of health improve treatment outcomes?
The social determinants of health go beyond an initial in-office exam. A physician can gain valuable insights during an appointment, but they rarely have the time to consider all the factors that contribute to good health. A growing body of research shows that by considering social determinants of health, including housing stability or substance-use disorders, it’s easier to reduce setbacks in treatment, unnecessary treatment expenses and hospital readmission rates.
What role do social services play in value-based care?
As more and more providers make the transition to value-based care, they’re entering value-based contracts with community provider networks. These provider networks work to improve health outcomes for patients outside of the hospital or clinical setting.
Many vulnerable people, including the elderly, drug-addicted and homeless, don’t have the necessary transportation to attend regular doctor’s appointments. If they do, they rarely have the funds to pay for prescription medication or other necessary aspects of treatment.
Without the resources to stay on top of their health, many chronic conditions such as high blood pressure, diabetes and chronic pulmonary obstructive disease are exacerbated and get worse. As a vulnerable patient’s health fails, they’re more likely to need emergency care, and in turn, hospital readmission. It’s a vicious cycle that requires attention.
How can Med USA help me provide better care for my patients?
Health care payments tied to value-based care are on the rise. In fact, a survey conducted by Health Care Finance News at the end of 2018 found that approximately 34% of medical payments were tied to value-based care, a significant increase from 2015. when only 25% of payments were.
If you’re in the process of transitioning from a fee for service model, it’s important you have the resources to make the transition as smooth as possible. This is especially true if you’re trying to reduce hospital readmission rates and improve patient outcomes. After all, a value-based care model relies almost solely on the care you’re able to provide. Therefore, you need to be able to spend quality time with each and every one of your patients.
That’s where we come in. At Med USA, we offer a variety of customized credentialing services designed to help you achieve your goals. These services include:
- Management and oversight
- Initial hire packet and enrollment design
- Provider/group enrollment assessment
- Medicare and Medicaid enrollment
- Out of state/regional payer enrollment services
- CAQH maintenance and updates
That’s just scratching the surface, though. We also offer outsourced medical coding and billing, medical marketing, and revenue cycle management.
By partnering with us, you can keep your hospital, clinic or medical facility running while providing the high-quality care you need to produce the best possible patient outcomes. With us handling your administrative duties, you can spend more time meeting with patients, listening to their concerns and understanding how the social determinants of health affect their lives and well-being.
The transition to a value-based care model isn’t easy, but the potential benefits are amazing. With hard work, dedication and a bit of assistance from us, we’re confident you’ll succeed. To learn more about our comprehensive suite of credentialing services, click here. We look forward to collaborating with you.