Access to safe and stable housing, nutritious food, transportation and education are just as important for health and wellbeing as going to the doctor for a checkup.
It may sound strange but the truth is that these factors – these social determinants of health – all play into overall health. Research has shown that only 20 percent of health can be attributed to medical care, while social and economic factors – like access to healthy food, housing status, educational attainment and access to transportation – account for 40 percent. Individuals struggling with these social determinants may experience poor health outcomes, increased health care utilization and increased health care costs.
Hospitals and health systems recognize this and have been leading the way to transform the health of their patients and their communities. From addressing housing insecurity to food deserts to youth violence, hospitals are working with community partners on their unique local needs. You can see just some examples here. And many hospitals are now using ICD-10 CM codes to record patient-level information related to social risk factors such as housing, literacy and education. The AHA is proud to support these efforts as a founding member of Aligning for Health, a collaboration working to enable states to weave together federal funding to better coordinate their delivery of social services and health care.
Social determinants are a critical component of patients’ health, and that’s why the AHA is so encouraged by Health and Human Services Secretary Azar’s remarks this week that the Centers for Medicare & Medicaid Services is working to provide more flexibility under Medicare and Medicaid for hospitals and health systems to more holistically address their patients’ health, including paying directly for their housing, healthy food and other solutions.
This is great news, and while the exact details of the proposal remain to be developed, the AHA commends HHS for announcing this important step in the right direction. We also applaud CMS for beginning to account for social risk factors in some of their value-based payment programs.
However, there’s still much to do – including developing this plan and putting it into action, as well as making sure that critical data on social risk factors is captured in electronic health records so it’s available to clinicians when they provide care. Taking these steps could be a game-changer for the health of America’s most vulnerable patients – and reduce overall health care spending.
The reality: Social determinants of health are an important piece of the health care puzzle. The AHA and America’s hospitals and health systems look forward to working with HHS and CMS on improving patients’ social conditions nationwide and advancing health in America.

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