On September 25, the National Academies of Sciences, Engineering, and Medicine (“National Academies”) issued a report outlining opportunities to integrate social care into the healthcare delivery system.  This report is likely to inform conversations among both federal and commercial payers, as they increasingly move towards value-based care systems and consider the implications of social determinants of health.

The National Academies identified 3 key factors necessary for integrating social care into healthcare delivery: inclusion of social care experts in the workforce, prioritization of a cohesive health information technology strategy, and implementation of financing models with adequate incentives for social care integration.

The report includes several recommendations intended to expand social services, better coordinate the roles of social services providers in care teams, and ensure optimal effectiveness of social services to improve health and healthcare:

• Design healthcare delivery systems that integrate social care; the report recommends assessing for social context, altering clinical care to account for social barriers, connecting patients with new resources, organizing new programs and investments within existing systems, and promoting policies to encourage creation and best use of resources for health and social needs.
• Invest in an integrated healthcare/social care workforce by developing standardized scopes of practice and allowing social care workers eligibility for payer reimbursement
• Develop an interoperable digital infrastructure to facilitate data sharing between social care and healthcare systems; the National Academies recommended a modernized approach to digitizing social care data and investing in technological infrastructure, including an initiative from the Office of the National Coordinator for Health Information Technology to enable seamless access to key consumer data to enhance care coordination and minimize organizational burden
• Create healthcare and social care integration financing structures and clearly define which social services may be reimbursable under Medicare and Medicaid
• Establish robust effectiveness research methodology for social care practices; the National Academies recommended that all stakeholders—including federal and state agencies, providers, payers, and private entities such as foundations—advance research on evaluating and implementing social care practices to better evaluate impact

What’s Next?

Both public and private payers are increasingly emphasizing opportunities to integrate social care into healthcare delivery. For example, due to a recent policy change from CMS, more MA plans are likely to invest in non-traditional care services, such as home safety modifications. The agency is currently modeling an Accountable Health Communities model that integrates community-based providers into care teams and could serve as a framework for other entities seeking to integrate social care into clinical workflows.

The increased focus on the integration of social services into healthcare delivery is an opportunity for traditional healthcare stakeholders, social services providers, and community-based organizations to collect and evaluate data around social determinants of health.

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