Screening for SDOH without a mechanism for addressing them is not only pointless but harmful. I won't talk to a doctor about my personal life, social circumstances, mental health, etc. It saves the doctor time and like you said none of these issues fall under clinical medicine. I don't need to feed some gigantic, opaque database.
Really great piece. I’m seeing this in the VBC orgs I work with (where clinics are being asked to operationalize social risk at a depth they were never designed for) I used to think of VBC as a clinical organization with a social care arm, but I’m starting to wonder if the end state is actually a care navigation and social care organization with clinical escalation capacity. It would be much simpler if social care did not need to be veiled in a clinical guise to be seen as legitimate, but given the political stigma around social care in the US, VBC may be the most workable vehicle we have right now to deliver the kind of support people actually need.
Every ACO I have spoken with relies on care coordinators/social workers to address SDOH. All of this entails creating a social management infrastructure, the cost of which is attributed back to physicians under the "total cost of care model."
And when healthcare costs keep rising, doctors become the scapegoats.
And I agree, it would be much better for society and for healthcare costs if we had separate social services programs where people could go directly for help.
Brilliant framing of the linguistic sleight of hand here. The SDOH to HRSN shift is dunno, almost like renaming "poverty" to "underresourced lifestyle choice" so we can code it. What's wild is that Z-codes basically turn physciains into compliance officers for social policy failure without giving them any actual budget authority or interventiontools.
Brilliant framing of the linguistic sleight of hand here. The SDOH to HRSN shift is dunno, almost like renaming "poverty" to "underresourced lifestyle choice" so we can code it. What's wild is that Z-codes basically turn physciains into compliance officers for social policy failure without giving them any actual budget authority or interventiontools.
Screening for SDOH without a mechanism for addressing them is not only pointless but harmful. I won't talk to a doctor about my personal life, social circumstances, mental health, etc. It saves the doctor time and like you said none of these issues fall under clinical medicine. I don't need to feed some gigantic, opaque database.
Really great piece. I’m seeing this in the VBC orgs I work with (where clinics are being asked to operationalize social risk at a depth they were never designed for) I used to think of VBC as a clinical organization with a social care arm, but I’m starting to wonder if the end state is actually a care navigation and social care organization with clinical escalation capacity. It would be much simpler if social care did not need to be veiled in a clinical guise to be seen as legitimate, but given the political stigma around social care in the US, VBC may be the most workable vehicle we have right now to deliver the kind of support people actually need.
Thank you for the insightful comment.
Every ACO I have spoken with relies on care coordinators/social workers to address SDOH. All of this entails creating a social management infrastructure, the cost of which is attributed back to physicians under the "total cost of care model."
And when healthcare costs keep rising, doctors become the scapegoats.
And I agree, it would be much better for society and for healthcare costs if we had separate social services programs where people could go directly for help.
Brilliant framing of the linguistic sleight of hand here. The SDOH to HRSN shift is dunno, almost like renaming "poverty" to "underresourced lifestyle choice" so we can code it. What's wild is that Z-codes basically turn physciains into compliance officers for social policy failure without giving them any actual budget authority or interventiontools.
Brilliant framing of the linguistic sleight of hand here. The SDOH to HRSN shift is dunno, almost like renaming "poverty" to "underresourced lifestyle choice" so we can code it. What's wild is that Z-codes basically turn physciains into compliance officers for social policy failure without giving them any actual budget authority or interventiontools.