The Role of Social Determinants of Health in Revenue Cycle Management
May 18, 2023
In recent years, healthcare reimbursement models have shifted from fee-for-service to value-based care, and the focus has shifted from quantity to quality. As such, healthcare providers must take into account social determinants of health (SDOH) when managing their revenue cycle. SDOH can be defined as the conditions in which people are born, live, work, and age, and they can significantly affect patient outcomes and financial performance.
The most successful healthcare organizations recognize the importance of SDOH in driving quality outcomes and financial performance. By understanding the social and environmental factors that can impact a patient’s health, providers can tailor their services in order to optimize patient outcomes and ensure financial stability. For example, providers may be able to identify and provide services to patients with a higher risk of poor health outcomes due to SDOH, such as:
- Access to nutritious food
- Safe housing
- Employment opportunities
To effectively address SDOH, healthcare organizations must have access to accurate and up-to-date data. This data should include a patient’s social and economic status, as well as any data collected from population health initiatives. Additionally, providers should leverage analytics and data science to identify trends and develop targeted interventions to improve patient outcomes and financial performance.
One example of an effective intervention is the use of predictive analytics to identify patients at risk of readmission within 30 days of discharge. By leveraging predictive analytics, healthcare organizations can identify specific at-risk patients and develop targeted interventions to reduce readmission rates.
In summary, healthcare providers must recognize the importance of SDOH in driving quality outcomes and financial performance. To effectively address SDOH, providers must have access to accurate and up-to-date data and leverage analytics and data science to identify trends and develop targeted interventions. By doing so, providers can optimize patient outcomes, reduce readmission rates, and ensure financial stability.