Will healthcare providers become social safety net providers, too?

A new report from the Commonwealth Fund lays out the economic incentive the Affordable Care Act (ACA) creates for healthcare providers to address social disparities along with medical needs.

According to the report, as millions more low- and modest-income Americans gain healthcare coverage under the ACA, social and economic circumstances that define health outcomes will become even more present in clinicians' offices. Providers that focus just on clinical needs will have a harder time meeting quality of care targets because poverty, unemployment, low educational attainment, and lack of access to healthy food and safe, suitable housing invariably affects overall health, the ability to follow care plans and even longevity.

Among the government and private payor policy changes highlighted in the report as factors that incentivize providing social services along with medical ones were enhanced reimbursement models that required integration of some types of social services in the care setting, shared savings programs/ACOs, hospital readmission penalties under Medicare, and capitated, bundled or global payment approaches.

In addition, the report authors wrote that there are some indirect economic benefits to assuming responsibility for helping with social factors that prevent patients from realizing optimal results from the clinical care provided. For one thing, primary care physicians are already dealing with these factors when they consult with patients and have little organizational help when the main reason a patient is not improving is social and not medical. Giving physicians support in caring for patients’ social needs can free them up to focus more of their time in the exam room on the medical problems they trained for and reduce provider frustration and burnout, the report contends.

The researchers also cited studies showing that interventions that address social needs improve patient satisfaction and loyalty.

“With this confluence of sound economics and good policy, investments in interventions that address patients’ social as well as clinical needs are starting to make good business sense,” the authors concluded.

The report was supported by funds from The Skoll Foundation and The Pershing Square Foundation. Both are considered toward the liberal side of the political spectrum and conservatives may well disagree that medical providers, particularly those that are primarily funded by government healthcare benefits, should be expanding into being social safety net providers.