How health care organizations should support social services

In a recent JAMA Health Forum article, Glied and D’Aunno ask whether health sector investment in social services is “a bridge too far” and raise concerns about differing priorities, skills, finances, and functions of the 2 sectors that question whether this is a good match for collaboration.

As health care organizations ponder their role, if any, in supporting social services, there is growing evidence of health benefits from certain investments in social services (including housing and nutrition). But it is hard to make a traditional return-on-investment (ROI) case for many instances of health systems funding social service programs. For instance, to the extent that this “upstream” social funding helps improve household and community health, it means reduced revenues to hospitals and fee-for-service medical practices—so, not good for business. Managed care organizations do have a stronger business incentive to address their enrollees’ health-influencing social conditions. Still, although there is evidence that certain investments in housing, nutrition, etc do yield health care savings, the direct ROI to the health sector is often questionable.