Waystar, a provider of cloud-based revenue cycle technology, released an industry survey examining patient perspectives around Social Determinants of Health (SDoH). The “2018 Consumer Perspectives on How Social Determinants Impact Clinical Experience,” report revealed 68% of Americans identified having challenges in at least one SDoH risk category. Of all patients in the “high risk” segment, 60% have never discussed their issues with a provider or their insurance company.
SDoH categories included financial security, food insecurity, social isolation, housing insecurity, addiction, transportation access, and health literacy. Consistent across payer classes (government-funded versus commercial insurance), the most commonly reported SDoH issues were financial insecurity and social isolation.
Improving these categories for patients can have overwhelmingly positive effects on the patient’s health and the country’s overall healthcare system. But in an era of health system transformation, providers, healthcare organizations and payers still lack the tools, programs and community partnerships required to identify and address the patient needs. The data identified an exponential relationship in missed medical appointments related to increased SDoH risk. Additionally, the survey found that efforts to identify and mitigate SDoH risk are far from universal. The findings showed only 22% of consumers with SDoH stress have discussed these issues with their physician.
Efforts to engage patients on SDoH issues are found to be frequently misapplied; the majority of conversations about SDoH challenges occur with patients least likely to be affected by them and less likely to accept assistance even if they are affected. As a result, almost half (46%) of patients offered programs and services to help address SDoH challenges, declined to accept.
Additional key findings include:
- Even in the healthiest of categories surveyed, more than one in five consumers self-reported having high SDoH risk.
- Of all patients in the “high risk” segment, 60% have never discussed their issues with a provider or their insurance company.
- Government-funded insurance pools, Medicare or Medicaid, have the largest high-stress share with 33% having high stress in three or more areas, compared to 21% of the commercial insurance population being “high risk.”
- While almost half decline assistance, those who discuss SDoH challenges with a physician or nurse are more likely to accept help than those who speak with an insurance representative.
- Younger consumers are twice as likely to have been engaged in a discussion of their SDoH challenges but are less receptive to assistance.
