Tuesday, October 29, 2019

NQF to Address Social Determinants of Health with Payment Innovation


NQF recommends aligning policy and improving the collection of standardized data to address the social determinants of health.
October 25, 2019 - To address individuals’ social determinants of health, the National Quality Forum (NQF) recommends aligning policy and payment across public and private stakeholders, improving the use and collection of standardized social determinants of health data and designing incentives to address social determinants.
Through an initiative supported by the Aetna Foundation, NQF collaborated with a diverse group of experts to identify quality and payment innovations to effectively address the social determinants of health. 
“To improve our nation’s health, we need to begin addressing social determinants,” said Rep. Judy Chu, D-California, in a statement. “The release of these recommendations is a critical step towards aligning policies and funding to move healthcare stakeholders and community leaders into action.”
In the last decade, healthcare stakeholders have increasingly recognized that a person’s zip code is a better indicator of health than his or her genetic code. NQF noted that the environments in which individuals live, work, and play can account for almost 60 percent of health outcomes.
“Many communities — including some I represent in the Bronx and Westchester — suffer from severe inequities in accessing quality, affordable healthcare,” Rep. Eliot L. Engel, D-New York, said in a statement. “We can address these challenges by better aligning policies and funding that help reduce disparities and improve access to care.”
While most payers, providers, and community leaders recognize that addressing the social determinants of health is key to improving health, only 24 percent of hospitals currently screen for social determinants when treating patients. This indicates an opportunity to increase data sharing and collaboration among communities and industry stakeholders to further address social determinants
“Social determinants of health represent one of the top opportunities to advance healthcare improvement on a national level,” said Rep. Buddy Carter, R-Georgia, said in a statement. “I look forward to working with NQF to examine ways to create better opportunities for disadvantaged individuals living in our communities.”
With the support of the Aetna Foundation, NQF convened nearly 60 healthcare stakeholders from across the country to discuss national strategies, barriers, and recommendations for addressing social determinants through payment and quality innovation. 
“Advancing quality and payment innovation to reduce health disparities can enhance the already increasing focus on how SDOH are influencing the health of our nation and our communities,” Garth Graham, MD, vice president of community health and impact at CVS Health and president of the Aetna Foundation, said in a statement.
“Developed in collaboration with groups across the health care system, these comprehensive recommendations provide a clear path on the best use of payment and investment as key levers to address SDOH,” he added.
NQF also hosted a Congressional Hill Briefing on October 24 to discuss recommendations, bringing together bipartisan congressional leadership. 
One panel shared patient, payer, and provider perspectives to discuss the implications of the recommendations for policymakers, as well as examples of payment and quality innovations, and the importance of partnerships in social determinants of health initiatives.
“Social determinants of health play as large a role in a person’s health as their genes. While access to healthcare services is essential, it is only half the story,” said Rep. Tom Cole, R-Oklahoma, in a statement.
“In order to continue moving our public health programs toward cost-effective, value-based care, we must focus on addressing the socioeconomic and behavioral factors that influence Americans’ health,” he added.
Adequately addressing the social determinants of health will require transparency, cooperation, and inclusion across the nation, at all levels. NQF is calling on stakeholders to support and implement the recommendations. 
“We know we cannot improve health solely through clinical settings,” said NQF President and CEO Shantanu Agrawal, MD, in a statement. “Addressing social determinants of health is key to driving meaningful health improvement across populations.”
“These recommendations were informed by voices across the healthcare and community and will guide leaders on what interventions they should invest in, and which payment models can most positively impact health outcomes,” he added.

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