NQF Leads National Call to Address Social Determinants of Health through Quality and Payment Innovation

Categories: In The Media and Policy.
Diverse healthcare stakeholders recommend key actions to address SDOH and drive equitable health improvements across the nation.
The National Quality Forum (NQF) released a national call to action on October 24, 2019, identifying recommendations vital to helping the healthcare ecosystem address Social Determinants of Health (SDOH). Through an initiative supported by the Aetna Foundation, an independent charitable and philanthropic affiliate of CVS Health, NQF collaborated with a diverse group of experts to identify quality and payment innovations to systematically address SDOH, which can account for almost 60 percent of health outcomes.1 The recommendations focus on aligning policy, payment, and measurement across public and private stakeholders; improving the collection, use, and sharing of standardized SDOH data; as well as funding efforts and designing incentives to address SDOH.

Over the last decade, there has been growing recognition that a patient’s zip code is a better indicator of his or her health outcomes than a genetic code.2 The contributing factors, known as social determinants of health, are community-level conditions in the environments in which people live, work, play, worship, and age.

“Many communities—including some I represent in the Bronx and Westchester—suffer from severe inequities in accessing quality, affordable health care. We can address these challenges by better aligning policies and funding that help reduce disparities and improve access to care. I am pleased to work with the National Quality Forum on these important issues,” said Rep. Eliot L. Engel (D-NY-16).

“To improve our nation’s health, we need to begin addressing social determinants,” said Rep. Judy Chu (D-CA-27). “The release of these recommendations is a critical step towards aligning policies and funding to move healthcare stakeholders and community leaders into action.”

“Social determinants of health represent one of the top opportunities to advance health care improvement on a national level,” said Rep. Buddy Carter (R-GA-01). “I look forward to working with NQF to examine ways to create better opportunities for disadvantaged individuals living in our communities.”

“Social determinants of health play as large a role in a person’s health as their genes. While access to health care services is essential, it is only half the story,” said Rep. Tom Cole (R-OK-04). “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. My colleagues and I look forward to doing our part to get us there.”

The majority of payers, providers, and community leaders recognize that addressing SDOH is key to driving better outcomes and building healthier communities. Currently, only 24 percent of hospitals screen for social determinants of health when treating patients.3 This points to opportunities for increased data sharing and collaboration among communities and healthcare industry stakeholders to adequately address SDOH.

With the support of the Aetna Foundation, NQF convened nearly 60 diverse healthcare stakeholders from across the country to discuss national strategies, barriers, and recommendations for addressing SDOH through payment and quality innovation at the SDOH Payment Summit in August 2019.

“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,” said Garth Graham, M.D., vice president of community health and impact at CVS Health and president of the Aetna Foundation. “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.”

Understanding the national commitment needed to achieve health equity, NQF hosted a Congressional Hill Briefing on October 24, 2019 to discuss the recommendations. The briefing convened bipartisan congressional leadership and featured a panel with patient, payer, and provider perspectives to discuss the implications of the recommendations for policymakers; examples of SDOH payment and quality innovations; and the importance of community and patient partnerships in SDOH initiatives.

“We know we cannot improve health solely through clinical settings. Addressing social determinants of health is key to driving meaningful health improvement across populations,” said NQF President and CEO Shantanu Agrawal, MD, MPhil. “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.”

Addressing SDOH will require transparency, cooperation, inclusion, and shared priorities across the nation at all levels. NQF calls on diverse stakeholders across the healthcare ecosystem and at the community level to come together to support and implement the recommendations (PDF) from the SDOH Payment Summit.

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About National Quality Forum
The National Quality Forum works with members of the healthcare community to drive measurable health improvements together. NQF is a not-for-profit, membership-based organization that gives all healthcare stakeholders a voice in advancing quality measures and improvement strategies that lead to better outcomes and greater value.