Insurers and hospital systems need to change the way they view initiatives that address the social determinants of health, according to a policy brief in Health Affairs. The key, according to researchers, is patience because the benefits of the programs are likely to emerge slowly. “Drawing on lesser-known economic models and available data, we show how a properly governed, collaborative approach to financing could enable self-interested health stakeholders to earn a financial return on and sustain their social determinants investments,” write authors Len Nichols, a health policy professor at George Mason University, and Lauren Taylor, a doctoral candidate in health management at Harvard Business School.
Nichols and Taylor say one of the main problems hospitals and insurers see in the launching of such programs is that it is difficult to gauge return-on-investment. Other reasons for underinvestment in social determinant programs include not being sure exactly how to deliver social services to a targeted group, since that work is done by public programs that aren’t connected to hospitals or insurers. Also, the patient may get well and then switch insurers, a long-term concern of health plans stemming from the 1990s when disease management programs began to come into play.
As an antidote, Nichols and Taylor suggest that a financially neutral broker, such as a not-for-profit local charity, be enlisted to pinpoint where funded services are most needed. The broker would keep financial information confidential and be impartial.