Health-Related Social Needs: Three Trends in Leveraging Community Partnerships

Leading health authorities have increasingly emphasized how non-medical factors such as socioeconomic status, education, employment, housing, food security, and community support have an outsized impact on health outcomes. By some recent U.S. estimates, clinical care accounts for only 20% of county-level variation of health outcomes in the United States, with the social determinants of health (SDOH) responsible for as much as 50%. SDOH are now widely acknowledged as critical not only to improving individual health and population health, but also to meeting federal health equity goals. Yet conventional models of health care delivery still struggle with interventions to impact individuals’ health-related social needs (HRSN). One reason is that health plans and health care providers must look to nontraditional partnerships with organizations that have not historically been part of the health care industry to meet these needs.

We highlight three trends associated with partnerships to address HRSNs:

• Medicaid and Medicare health plan initiatives;
• Local and regional data sharing efforts; and
• Risk mitigation in collaborations between health care providers and community partners.

Health care providers and health plans involved in any of these trends — or looking to become involved — must navigate complex and interrelated reimbursement, privacy, compliance, and fraud and abuse issues. It is critical to consult with counsel when developing new initiatives targeting the SDOH and HRSNs to ensure legal concerns are evaluated and addressed.