ACOs aiming to improve health through patients' nonmedical needs

Half of accountable care organizations address their patients' nonmedical needs, such as housing stability or food insecurity, in an effort to improve overall health, according to a new study.

An estimated 40% to 90% of health outcomes are due to nonmedical factors such as homelessness, or food insecurity. Researchers from the Dartmouth Institute for Health Policy and Clinical Practice and the University of California - Berkeley set out to determine how ACOs were addressing these needs.

“There's increasing evidence that shows the positive effects on healthcare outcomes when patients' nonmedical needs are addressed,” said lead author Taressa Fraze, Ph.D. “But up until now, we haven't known if, and to what extent, healthcare organizations operating under new payment models are addressing them.”

Fraze's findings, published in the November issue of Health Affairs, showed that 16 of the 32 ACOs interviewed as part of the study addressed patients needs that “were not clinical in nature but had the potential to affect health.” The most commonly addressed nonmedical needs were linked to housing, transportation and food insecurity.

Each ACO took on its beneficiaries' nonmedical needs in different ways. Some work to identify patients who needed housing support upon hospital discharge, while others may provide nutrition assistance programs for patients with specific conditions.

Despite the ACOs' efforts to address these needs, barriers such as lack of financial and staffing resources, lack of expertise and competing clinical priorities still exist, researchers noted. The study's findings should provide the Centers for Medicare & Medicaid Services with insights for its policy initiatives like Accountable Health Communities.

"The intersection between patients' medical outcomes and social service programs is complex, but it's very important we study it further to determine which activities are effective at addressing patients' needs while reducing costs and improving the quality of care," Fraze said.