Case Management

Experts answer questions about how to better provide social support to patients

Case Management Insider, December 30, 2014

Healthcare experts today are increasingly focused on things besides medicine that help to keep people well, including social factors such as access to food and shelter, money to pay for treatments, and education.

A patient who doesn’t have enough money for food can’t be expected to manage his or her diabetes effectively, so increasingly healthcare organizations are stepping in to fill those gaps.
On September 30, the Commonwealth Fund, a New York City-based private foundation that aims to promote health system improvements, tackled this topic in a webinar called “The Business Case for Addressing Patients’ Social Needs in Health Care Delivery.”  
The webinar was presented by Deborah Bachrach, partner at Manatt, Phelps & Phillips in Albany, New York; Jennifer DeCubellis, assistant county administrator–health, Hennepin County, Minnesota; and Jeremy Boal, M.D., executive vice president for clinical operations and chief medical officer at Mount Sinai Health System in New York. At the end of the presentation, the speakers fielded some questions about the topic of providing social support for patients. The following questions and answers from the webinar may help your organization get a better sense of its own role in this issue.
Below are summaries of the questions and answers from the show.
Q: Should the healthcare industry develop its own mechanisms to address social deficits that affect health or should it focus more on linking patients to community-based organizations that focus on specific diseases?
A: I think the answer is that we should be doing both. Hospitals are increasingly consolidating into larger health systems that are going to need to take responsibility for the health of the population. We all know that providing care to sick patients can be costly. It’s far less expensive to focus on prevention. Hospitals can not only help to provide some of the services patients need to effectively prevent or manage chronic diseases, but also to create durable partnerships with outside organizations to share this responsibility.
Hospitals and health systems should consider providing financial support to the community organizations that are making a difference for patients. The incentive for healthcare organizations to do this is to bring overall costs of healthcare down. The social services sector is often underfunded. By integrating it into the healthcare system it’s a win-win situation for everyone.
Q: How can make a difference using these initiative and how can you get buy in for them from different sectors?
A: One of the best ways to do this is to analyze your organization to find out where specific problems lie. Many organizations identify utilization problems. For example, one organization looked at its records and found high utilization in the emergency department for patients suffering from dental pain. This was problematic because the ED is high cost, and it required staff members to provide pain management for what is often a highly chemically dependent population. Referring patients to outside dentists didn’t always solve the problem. Instead, what the organization did is looked for a means to solve the issue in house. The organization formed an on-site dental clinic where these patients could go when they presented to the ED, saving money and improving outcomes.
Q: What is the best way for hospitals to address social deficits by creating their own programs or referring patients to community organizations?
A: I think health systems should expand themselves to provide for a broader array of patient needs. But they can’t be all things to all people. What they should do is focus on their strengths and augment those areas while outsourcing other jobs to community organizations while sharing dollars.
Consider hosting community services on site, even if they are run by an outside organization. Referrals, which involved paperwork and handoffs, often fail, so it’s often better to bring the partner on site where patients have easy access.
The December 2014 issue of HCPro’s Case Management Monthly covers this webinar in-depth and features a discussion with experts from the Commonwealth Fund.


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