Levels of HRSN & SDH integration framework

In recent years, as moves to value-based payments and place-based community health improvement have accelerated, efforts to coordinate and integrate healthcare and social service approaches to health-related social needs (HRSNs) and social determinants of health (SDH) have increased. Despite the spread of these efforts, few updated taxonomies currently exist to describe the levels of HRSN and SDH integration. •As a concept and term, “SDH” is widely and inconsistently used by healthcare stakeholders to reference everything - from clinic-based screening of HRSNs, analytic projects that assess “social risk” data, and partnerships with social service providers to improve “population health” to participation in data sharing collaboratives and collective impact approaches that address community -wide SDH and engagement of hospitals as “anchor institutions” for community and economic development. •While the empiric evidence base is still growing, the integration of HRSNs and SDH in healthcare is widely believed to be essential to the pursuit of improving health and health equity among defined populations, if not entire communities. Increasingly, stakeholders are exploring how integration of HRSNs and partnerships to improve SDH can advance the healthcare “quadruple aim” - improve the experience of healthcare, improve population health outcomes, lower total and per-capita costs of care, and increase joy and resilience among professionals. Meanwhile, social service providers are weighing the costs and benefits of healthcare partnerships in relation to their own mission and bottom line.