The healthcare industry has made significant strides in recognizing the impact of Social Determinants of Health (SDOH) on patient outcomes. According to the CDC, up to 80% of health outcomes are determined by non-clinical factors, such as housing, transportation, education, and access to nutritious food. Addressing these factors is especially critical in
Medicaid populations, where social and economic disparities often result in poorer health outcomes and higher healthcare costs.
Recent data shows that approximately 65% of health plans have started integrating SDOH into their care strategies, a reflection of its growing importance in value-based care models. However, capturing and utilizing SDOH data effectively remains a challenge. Many organizations lack the infrastructure to combine SDOH data with clinical information, leaving a gap in their ability to identify and address patients’ most pressing needs.
For Medicaid programs, addressing this gap is more important than ever. CMS has increasingly emphasized health equity as a priority, with new regulations requiring plans to demonstrate how they are addressing social determinants in their populations. Meeting these requirements isn’t just a regulatory necessity; it’s also an opportunity to improve outcomes and lower costs. For example, providing transportation to medical appointments has been shown to reduce missed visits and emergency room usage, ultimately resulting in better chronic disease management.
Technology is playing a critical role in making SDOH actionable. Platforms that integrate SDOH with clinical and claims data give care teams a comprehensive view of patients, enabling them to design more targeted interventions. For instance, by identifying patients at risk of food insecurity, organizations can connect them to local food programs,
improving both their nutrition and overall health.
As Medicaid programs continue to evolve, SDOH will remain a cornerstone of effective population health management. Organizations that invest in strategies to capture, analyze, and act on SDOH data will not only meet compliance requirements but also drive meaningful improvements in care delivery.