Momentous times for social needs screening: Should hospitalists ride the tide or create the waves?

This is a momentous time to engage in hospital-based work focused on screening for social determinants of health (SDOH). Pediatric hospitalists are becoming increasingly aware of how SDOH, or family’s living conditions, may impact health care utilization, exacerbate chronic conditions, affect the severity of presentation and discharge planning, and influence morbidity and mortality. Many national incentives for inpatient SDOH screening have recently emerged, such as new regulations established by the Centers for Medicare and Medicaid Services, which require screening for health-related social needs (HRSN), or SDOH that negatively impact health, as part of their Inpatient Quality Reporting. Joint Commission-accredited organizations are also now required to address health care disparities as a quality and safety priority by assessing HRSN and providing referrals. Additionally, the White House recently issued a historic “United States (US) Playbook to Address Social Determinants of Health,” which called for more flexible federal spending to address adverse SDOH. This includes a path for nonprofit hospitals to meet community benefit spending requirements by funding SDOH initiatives like food security and nutrition programs. In addition, hospitals may be incentivized by the US News and World Report, which recently added health equity measures for hospitals, including the collection of patient data on HRSN and documentation of efforts to address disparities through quality improvement and community partnerships. Although these national incentives are in place, our work on screening for SDOH in the hospital has only just begun.