By Sara Heath
- The social determinants of health continue to come front and center in the healthcare industry, as doctors continue to identify these social risk factors as critical to patient health and the future of medicine.
Nearly three-quarters of doctors agree that social determinants of health will put the biggest strain on the healthcare industry come 2021, according to the third part of The Physicians Foundation 2020 Survey of America’s Physicians.
Another 44 percent said addressing health equity and inequity will be key for ensuring patient access to care, the survey showed.
These findings come as the healthcare zeros in on health equity and the social determinants of health and structural issues that shape it. The COVID-19 pandemic has shone a spotlight on stark health disparities, mainly between Black and White patients, and more providers are focused on addressing the inequities that have forged disparities.
Although structural inequality is a strong factor in those inequities, the social determinants of health also play a role and are front and center for physicians moving into 2021.
READ MORE: Patient Engagement Tools Support Social Determinants of Health
Thirty-four percent of physicians said that social determinants of health will drive the majority of healthcare demand in the coming year, the survey showed.
In fact, more and more physicians are acknowledging that addressing social risk factors is more important than addressing access to healthcare and clinical quality.
Forty-percent of physician respondents agreed that socioeconomic issues—income, job security, educational attainment, and family support—are the most pressing social determinants of health. These factors influence other downstream social determinants of health. Addressing income inequality could help address housing security issues, for example.
Another 30 percent of respondents said health behaviors, like diet, exercise, or drug use, are significant social determinants of health.
Finally, 20 percent identified access to healthcare services, and 10 percent tapped environmental factors (clean air, for example) as the top social determinants of health.
READ MORE: Outlining Social Services Options Key to SDOH Screening
This latest Physicians Foundation survey did not look at how many patients are affected by social determinants of health, although previous iterations did. The 2018 Survey of America’s Physicians found that 57 percent of doctors said all or many of their patients experienced at least one social determinant of health. Just 1 percent of physician respondents said none of their patients have these experiences.
This trend is likely to be more salient given the context of the pandemic and the economic downturn it has brought.
But physicians are largely feeling disempowered in helping patients to address these social risk factors, the survey showed.
“Moreover, physicians who do take steps to address SDOH find this work generally goes uncompensated and is burdensome in the context of a health care system that is still designed primarily to treat (and pay for treating) acute illness,” survey authors explained. “As a result, physicians bear the burden when ‘social risk’ is not accounted for in payment models or risk adjustment.”
A majority of physician respondents agreed changing those issues would be a boon for the healthcare industry. Thirty-two percent said that providing reimbursement for physician-directed referrals for social determinants of health is extremely important for moving healthcare forward. Another 31 percent agreed this is important, while only 6 percent said reimbursement isn’t important at all.
READ MORE: How Do Social Determinants of Health Affect Patient Wellness?
Younger, female, employed, and primary care physicians were more likely to agree with social determinants of health reimbursement than their counterparts, findings showed.
Additionally, 38 percent of physicians agreed a patient’s social risk factors should be included in a health payer’s risk score. Patients with significant social determinants of health burden should be categorized as highly complex, those physicians said.
“Independent physicians have been emotionally and financially drained from COVID-19. As we recover during these uncertain times, physicians’ voices need to be heard,” Ripley Hollister, MD, a board member and chair of The Physicians Foundation’s Research Committee, said in a statement. “This is our chance to get it right, not only for our physicians but for the patients they serve and the overall health care system.”
Additional findings zeroed in on patient access to care, chronic disease management, and how those concepts are linked. For example, 86 percent of physicians said chronic conditions made worse by delayed care during the pandemic will put the biggest strain on the health industry come 2021.
Other physicians mentioned healthcare affordability challenges to access to care. Sixty-seven percent of physicians reported that 11 percent of their patients delay or decline treatment due to costs. Forty-four percent said about a quarter of their patients (26 percent) delay or decline treatment for that reason.
The survey also outlined key factors that could positively influence the healthcare industry moving forward, such as physician views on health payer landscape change. Most physicians agreed a hybrid public and private payer landscape would best serve them and their patients. Physicians also reported a need to streamline the prior authorization process.
“As we’ve seen from our data over the past few months, COVID-19 has had a tremendous impact on physicians. We know that burnout continues to grow as a result of frustration with the pandemic and our current health care system, and you see that in this survey’s results,” said Gary Price, MD, president of The Physicians Foundation.
“Physicians are fed up with being unable to practice medicine the way they were trained to do so. They are tired of fighting insurers and PBMs to get patients the treatments they need, and they want change. They want to be able to offer the services patients need and want.”
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November 05, 2020 at 08:30PM
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