Addressing Health-Related Social Needs: Value-Based Care or Values-Based Care?

Berkowitz, Seth A.; Baggett, Travis P.; Edwards, Samuel T.

doi:10.1007/s11606-019-05087-3

Cited by 29 publications

(27 citation statements)

References 10 publications

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“…Efforts are increasing to address individuals' social needs as a strategy to address social determinants, although these approaches only indirectly address structural issues. [43][44][45][46] For example, some schools provide breakfast to address the social need for healthy food among individual students. However, to sufficiently address the affordability of healthy foods at the population level, social determinants such as food deserts must be addressed.…”

Section: Living Environmentsmentioning

confidence: 99%

“…Financial incentives can motivate health care providers and systems to institutionalize a social determinants perspective (eg, routine screening for social determinants) in health care. The ongoing shift away from volume-based care toward value-based care 120 or, more recently, values-based care (improving health irrespective of cost savings) 44 could help to foster quality and accountability for reducing disparities in cancer. At the same time, concerns have been raised that providers may be less willing to care for patients with social risk.…”

Section: Support Models Of Care That Consider Social Riskmentioning

confidence: 99%

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Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy

Alcaraz

Wiedt

Daniels

et al. 2019

CA A Cancer J Clinicians

340

273

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Although cancer mortality rates declined in the United States in recent decades, some populations experienced little benefit from advances in cancer prevention, early detection, treatment, and survivorship care. In fact, some cancer disparities between populations of low and high socioeconomic status widened during this period. Many potentially preventable cancer deaths continue to occur, and disadvantaged populations bear a disproportionate burden. Reducing the burden of cancer and eliminating cancer‐related disparities will require more focused and coordinated action across multiple sectors and in partnership with communities. This article, part of the American Cancer Society's Cancer Control Blueprint series, introduces a framework for understanding and addressing social determinants to advance cancer health equity and presents actionable recommendations for practice, research, and policy. The article aims to accelerate progress toward eliminating disparities in cancer and achieving health equity.

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Section: Living Environmentsmentioning

confidence: 99%

Section: Support Models Of Care That Consider Social Riskmentioning

confidence: 99%

Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy

Alcaraz

Wiedt

Daniels

et al. 2019

CA A Cancer J Clinicians

340

273

View full text Add to dashboard Cite

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“… 2 Social risks are associated with higher disease prevalence, worse disease control, and resultant patterns of hospital utilization that include increased ED utilization 3 , 4 and higher healthcare costs. 5 Recent policy changes, including the creation of accountable care organization (ACO) models, are increasing emphasis on social risk by mandating screening and allowing organizations to use payments to address social risk. 6 Both the Accountable Health Communities project 7 and several Medicaid ACO demonstration studies are currently studying strategies for social risk screening and referral to community resources.…”

Section: Introductionmentioning

confidence: 99%

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

Samuels‐Kalow

Molina

Ciccolo

et al. 2020

WestJEM

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Introduction: Social risks adversely affect health and are associated with increased healthcare utilization and costs. Emergency department (ED) patients have high rates of social risk; however, little is known about best practices for ED-based screening or linkage to community resources. We examined the perspectives of patients and community organizations regarding social risk screening and linkage from the ED. Methods: Qualitative interviews were conducted with a purposive sample of ED patients and local community organization staff. Participants completed a brief demographic survey, health literacy assessment, and qualitative interview focused on barriers/facilitators to social risk screening in the ED, and ideas for screening and linkage interventions in the ED. Interviews were conducted in English or Spanish, recorded, transcribed, and coded. Themes were identified by consensus. Results: We conducted 22 interviews with 16 patients and six community organization staff. Three categories of themes emerged. The first related to the importance of social risk screening in the ED. The second category encompassed challenges regarding screening and linkage, including fear, mistrust, transmission of accurate information, and time/resource constraints. The third category included suggestions for improvement and program development. Patients had varied preferences for verbal vs electronic strategies for screening. Community organization staff emphasized resource scarcity and multimodal communication strategies. Conclusion: The development of flexible, multimodal, social risk screening tools, and the creation and maintenance of an accurate database of local resources, are strategies that may facilitate improved identification of social risk and successful linkage to available community resources. [West J Emerg Med. 2020;21(4)964-973.] been used to describe these individual-level, adverse social determinants of health. For the purposes of this paper, we will term these "specific adverse social conditions that are associated with poor health" as social risk. 2 Social risks are

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“…Research is increasingly focused on health‐related social needs, their association with worse health outcomes, and the development of interventions to address them 23 . In the context of cancer care, several previous studies have estimated the prevalence of food insecurity and described interventions to improve food insecurity.…”

Section: Discussionmentioning

confidence: 99%

“…Patient‐reported outcomes, including HRQOL, are critical measures for studies of social needs 14,23 ; however, evidence demonstrating an association between social needs and HRQOL among African American cancer survivors is currently lacking. To address this gap, we estimate associations between social needs and HRQOL in a population‐based cohort of African American cancer survivors in Detroit, Michigan.…”

Section: Introductionmentioning

confidence: 99%

Social needs and health‐related quality of life among African American cancer survivors: Results from the Detroit Research on Cancer Survivors study

Hastert

McDougall

Strayhorn

et al. 2020

Cancer

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BackgroundSocial needs may affect cancer survivors' health‐related quality of life (HRQOL) above and beyond sociodemographic and cancer‐related factors. The purpose of this study was to estimate associations between social needs and HRQOL.MethodsResults included data from 1754 participants in the Detroit Research on Cancer Survivors cohort, a population‐based study of African American survivors of breast, colorectal, lung, and prostate cancer. Social needs included items related to food insecurity, utility shutoffs, housing instability, not getting health care because of cost or a lack of transportation, and perceptions of neighborhood safety. HRQOL was measured with the validated Functional Assessment of Cancer Therapy–General (FACT‐G). Linear regression models controlled for demographic, socioeconomic, and cancer‐related factors.ResultsMore than one‐third of the survivors (36.3%) reported social needs including 17.1% of survivors reported 2 or more. The prevalence of social needs ranged from 14.8% for food insecurity to 8.9% for utility shutoffs. FACT‐G score differences associated with social needs were –12.2 (95% confidence interval [CI] to –15.2 to –9.3) for not getting care because of a lack of transportation, –11.3 (95% CI, –14.2 to –8.4) for housing instability, –10.1 (95% CI, –12.7 to –7.4) for food insecurity, –9.8 (95% CI, –12.7 to –6.9) for feeling unsafe in the neighborhood, –8.6 (95% CI, –11.7 to –5.4) for utility shutoffs, and –6.7 (95% CI, –9.2 to –4.1) for not getting care because of cost.ConclusionsSocial needs were common in this cohort of African American cancer survivors and were associated with clinically significant differences in HRQOL. Clinical oncology care and survivorship care planning may present opportunities to screen for and address social needs to mitigate their impact on survivors' HRQOL.

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Addressing Health-Related Social Needs: Value-Based Care or Values-Based Care?

Cited by 29 publications

References 10 publications

Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy

Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy

Patient and Community Organization Perspectives on Accessing Social Resources from the Emergency Department: A Qualitative Study

Social needs and health‐related quality of life among African American cancer survivors: Results from the Detroit Research on Cancer Survivors study

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