In the quest for value-based care, providers often overlook the most important factors of all – social determinants.
That’s according to Klaus Koenigshausen, CEO and founder of New York City-based MediQuire, a company that aims to transform the health of the Medicaid population.
As part of Healthy People 2020, the Office of Disease Prevention and Health Promotion (ODPHP) defines social determinants as “resources that enhance quality of life.” And they can have “a significant influence on population health outcomes,” ODPHP said. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency and other health services, and environments free of life-threatening toxins.
Without factoring in how social determinants play a part in health outcomes, value-based care will continue to evolve “at a snail’s pace,” Koenigshausen said. Bringing together medical, behavioral, financial and social data and using advanced analytics to understand how to improve patient outcomes can not only help to improve care, but it can reduce costs.
“Healthcare data analytics is at the cusp of producing really good predictive and prospective models, but most have yet to incorporate social determinants of health,” Koenigshausen added. “EHRs already hold a wealth of social determinants in unstructured text form and this can be used in predictive models to identify patients who are at high risk of deteriorating before it is too late.”
The use of traditional methods to predict health risks, such as prior claims, diagnoses codes, and even provider intuition, do not always reveal the most optimal care opportunities, Koenigshausen said.
One of the biggest factors in outcomes is where a patient lives. Poverty has a more significant impact on health than a patient’s genetic make-up, he says.
Koenigshausen will be speaking at HIMSS17 Conference and Expo in Orlando, along with Jennifer Daley, MD, former COO at UMass Memorial Health System, who has extensive experience in analyzing utilization, cost and quality data from large administrative databases.
In the session, titled, “Using Social Determinants of Health to Power Risk Contracts,” Koenigshausen and Daley will help uncover relationships between social drivers and health outcomes. The session is slated for Feb. 20 from 10:30-11:30 a.m. in Room 207C.
HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.
This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.