Where you live, learn, work, and play affects your health and potential risks to it, as well as the outcomes of care you receive, according to the Centers for Disease Control and Prevention (CDC). These conditions, known as social determinants of health (SDOH), have significant impact on health and wellbeing. Despite their importance, gaps exists in the ability to access SDOH data consistently and reliably and in the ability to incorporate that data into clinical practice, outcome measurement and payment models. NQF and the Aetna Foundation teamed up to try to better understand this complex issue and discuss potential approaches to improve the status quo.
The Aetna Foundation is a national foundation based in Hartford, Connecticut that supports projects to promote wellness, health and access to high-quality health care for everyone. The Foundation funded an NQF Strategy Session that brought together a panel of leaders and experts in social determinants of health, data analytics, risk adjustment, economics, and medicine. Their goal: develop a data driven, evidence-based, best practices approach to identifying, quantifying and accounting for the impact of SDOH on health outcomes. NQF Strategy Sessions offer an accelerated, customized process to address a specific healthcare or measurement need and help create tailored approaches or measure concepts to address that need.
SDOH encompass socioeconomic status (SES) and demographic factors. SES factors are the focus of the current NQF trial to determine when risk adjusting quality performance measures for SES is appropriate. The NQF Strategy Session panel identified priority SDOH that affect health outcomes, including poverty and employment, social and family support, housing, education and literacy, and food and healthy behaviors.
“No national approach exists to address the impact of social determinants of health on care quality and outcomes,” said Garth Graham, MD, MPH, president of the Aetna Foundation. “We’re pleased to work with NQF and experts from across healthcare and social services to address disparities in healthcare, which is a core focus of the Aetna Foundation.”
The approach resulting from the NQF Strategy Session envisions a large-scale initiative that, ultimately, would improve healthcare outcomes by addressing the impact of SDOH through efforts designed to influence clinical practice, outcome measurement, and payment.
“The concepts and ideas from this NQF strategy session hold the potential to affect change in medical practice and payment, and, ultimately, improve the health of individuals and communities, said Shantanu Agrawal, MD, MPhil, president and CEO of NQF. “We are looking forward to future efforts that build on the best practices of outstanding community-level efforts to address the impact of social determinants on health. Our nation needs data-driven resources, including measures, to truly improve care for all Americans.”
NQF will seek additional funding to pursue implementation of the panel’s recommended approach.