Historically, the incentives built into fee-for-service (FFS) payment models actually encouraged providers to ignore social determinants of health (SDH) that impact health outcomes.

For example, providers were financially rewarded when “frequent flyers” were readmitted, and it was easy to rationalize such factors as “out of scope”. Ignoring vulnerable populations’ socioeconomic factors may have been good for business in the past, but looking to the future, providers are now being forced to consider SDH’s impact.

But as concern has grown about the cost of care and the disparate outcomes suffered by disadvantaged communities, many provider organizations have undertaken programs to mitigate the impact of SDH at the community level. Too often these organizations commit resources to community health strategies without a coherent framework and focus on ROI. As a result, such efforts have yielded disappointing outcomes. Instead of broadly defined population health initiatives, providers must take a targeted, outcomes-focused approach.

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