News: Few hospitals, physician offices screen for key social needs

Despite increasing recognition of the importance of the social determinants of health, just 24% of hospitals and only 16% of physician offices in the U.S. screen for all five social needs prioritized by CMS, according to a new study published in the Journal of the American Medical Association (JAMA) Network Open.

For the study, researchers asked hospitals and physician offices if they screened for:

• Food insecurity
• Housing instability
• Utility needs
• Transportation needs
• Experience with interpersonal violence

Screening for interpersonal violence was the most common for both hospitals (75%) and physician offices (56%), followed by screening for transportation needs, while asking about utility needs was the least common, Revenue Cycle Advisor reported.

Most hospitals and physician offices screened for at least one social need, according to the study. Physician offices, however, were less likely to screen: 33% of physician offices reported no screening compared with 8% of hospitals.

The availability of resources may explain the discrepancy in screening rates between hospitals and physician offices, according to the study’s authors. Physician offices “may lack the financial or staffing resources to routinely screen in the course of clinical care,” they said. “Hospitals may have more resources, including staffing, financial, and technological, as well as more processes, protocols, and standardization in care delivery.”

According to the authors, hospitals must also adhere to federal regulations on patient safety for their CMS certification, which may explain why they are more likely to screen for social needs, according to Revenue Cycle Advisor.

To increase screening, hospitals and physician offices need financial support, according to the authors. “Payers could allow physicians and hospitals to bill for evidence-based programs, such as FoodRx, that have been shown effective at addressing needs and improving outcomes,” they said. “CMS could consider expanding care management billing to include managing care for patients who are both at risk and have clinically complex conditions in addition to social needs.”

Editor’s note: This article originally appeared in Revenue Cycle Advisor. To read the full study from JAMA, click here. To learn more about social determinants of health codes, read this article from the September/October edition of the CDI Journal. ACDIS is currently working on an article for the Journal on CDI’s role with population health initiatives. If you have experience in this area, please contact ACDIS Editor Linnea Archibald (larchibald@acdis.org).