Thread by @KBibbinsDomingo

New @NASEM_Health @theNAMedicine report “Integrating Social Care Into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health” #SocialCare

full report: nationalacademies.org/SocialCare

Summary in @JAMA_current

My THREAD 1/18

ja.ma/2opPlEz

Great committee of outstanding experts in medicine, public health, social work, healthcare financing, digital platforms, implementation sciences, nursing, law, gerontology, health equity #SocialCare cc: @djmasonrn @KedarMate @LisaCooperMD @KBDeSalvo (2/18)

Why this topic?

⬆️ healthcare spending, but outcomes lag

⬆️ focus on healthcare value

Social factors ▶️ health, but not necessarily addressed in healthcare

⬆️ activity integrating social care into healthcare -> need framework to design/evaluate/improve #SocialCare (3/18)

Who benefits?

Everyone’s health affected by social factors & anyone may have ⬆️ need (eg discharge, aging)

For some, social needs are multiple, chronic, & faced without resources

Addressing health-related social need important for health & health equity #SocialCare @RWJF 4/18

Will social care integration cost more?

*US spending on healthcare >> OECD countries
*US spends less in some social sectors, but more in others
▶️ investments are needed, but also about rebalancing, shifting definitions

Lots in report on global budgeting #SocialCare 5/18

Activities in healthcare that address social needs:

Be 🅰️ware of social determinants of health

Offer 🅰️ssistance & make 🅰️djustments for individual patients with social needs

🅰️lign with communities & 🅰️dvocate for policy change

The 5🅰️s #SocialCare (6/18)

Many different ways to be 🅰️ware of health-related social needs
- in clinical care for individual patient
- universal screening or targetted to high risk groups
- hotspotting
- awareness of community needs
#SocialCare (7/18)

Some great examples of 🅰️ssistance & 🅰️djustment in report

Healthcare sector may also address needs at the community level - 🅰️lignment & 🅰️dvocacy include partnering in X-sector coalitions & leveraging social, political, economic clout as anchor institutions

#SocialCare 8/18

3 essential elements for integrating social care into healthcare delivery

- appropriately staffed and well-trained workforce
- health information technology to support
- new financing models

#SocialCare (9/18)

Nice examples in this report on use of digital platforms that enable integration of social care into healthcare delivery in
🅰️wareness,
🅰️ssistance,
🅰️djustment,
🅰️lignment, and
🅰️dvocacy activities

#SocialCare 10/18

Lots in this report on implementation in integrating social care into healthcare delivery

Partnership between the healthcare and social care sector is important - here are some considerations & strategies related to external referrals

#SocialCare (11/18)

This @NASEM_Health @theNAMedicine report on integrating social needs into the delivery of healthcare outlines 5️⃣ goals to further this integration and groups recommendations under each goal #SocialCare (12/18)

Goal 1️⃣ recommendations address healthcare delivery systems
- focuses on need for leadership support, development of infrastructure, engaging stakeholders in developing models for integrating social care into healthcare delivery #SocialCare (13/18)

Goal 2️⃣ recs focus on workforce
- Social care workforce is key, as a part of interprofessional teams aware of #SDoH

social workers, community health workers, gerontologist, lawyers, others.

Recs address scope of practice, reimbursement, education
#SocialCare (14/18)

Goal 3️⃣ recs focus on digital infrastructure for social care integration

connecting social service organizations to each other & to the healthcare sector

protecting rights of consumers critical

#SocialCare (15/18)

Goal 4️⃣ recs focus on financing models that would support social care integration, addressing @CMSGov @HHSGov & states

important to note that while policy changes would support more integration, many more activities allowed even within current regulations

#SocialCare (16/18)

Goal 5️⃣ recs address need for more research & evaluation addressing social care integration

The evidence is good, but still need more.....
demonstration projects, evaluation, common metrics, clearinghouse

#SocialCare (17/18)

FIN (18/18)

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