Address Social Determinants of Health (SDOH) Through Care Management
ThoroughCare
Integrated care coordination software that enables healthcare practices to seamlessly deliver value-based care.
Care management is ideally positioned to screen for social determinants of health (SDOH) and provide resources to help overcome associated barriers.
Recognizing and addressing SDOH is becoming a standard part of delivering patient-centered care that achieves three goals:
According to the Centers for Medicare & Medicaid Services, providers across 32 Accountable Health Communities will screen seven million beneficiaries over the next five years.
“Growing evidence shows that if we deal with unmet Health-Related Social Needs like homelessness, hunger, and exposure to violence, we can help undo their harm to health,” CMS states.
Medicare programs, like Chronic Care Management, support reimbursable time that can be used to coordinate care and resources. Chronic care programs can also help patients with goal-setting, referrals, and self-management.
Providers can also use the new standalone code, G0136, to administer a standardized, evidence-based SDOH assessment. With CMS support for screening and care management services, providers can remove access barriers by:
ThoroughCare’s comprehensive care management platform includes everything to enroll patients, coordinate care, and capture reimbursement. Our software supports evidence-based assessments to enable care planning for chronic conditions, as well as identify health risks and SDOH within an Annual Wellness Visit.
Because social determinants can thwart a patient’s best efforts, addressing them complements the goals of care management. These programs offer unique features to help patients realize their health goals with confidence.
SDOH and Care Management: Engage, Assess, Address
Engaging patients around social determinants entails creating, or enhancing, each healthcare organization’s policies and systems, as well as each professional’s set of behaviors, attitudes, and beliefs.
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New Code G0136 for Social Determinants Screenings
Medicare now reimburses providers for delivering SDOH screenings. This can be valuable to identify known or suspected SDOH needs that may interfere with the diagnosis or treatment of a patient.
Addressing Transportation Barriers Improves Care
Research shows that 5.8 million people in the US do not receive medical care annually due to transportation issues. When providers identify barriers, they improve outcomes.
Consider Combining Care Management Services
Just as Chronic Care Management can connect patients to SDOH screenings and Annual Wellness Visits, other programs support complementary features.