Understanding patients’ interest in healthcare-based social assistance programs

Over the past decade, increased recognition of the impact of social and economic factors such as financial strain, food insecurity, and housing instability on health and healthcare utilization, has led to growing interest in and recommendations for healthcare sector efforts to address social risk factors as part of clinical care. The American Academy of Pediatrics and the American Academy of Family Physicians both recommend that primary care providers screen and address social risk factors as part of routine primary care visits. The Center for Medicare and Medicaid Innovation is testing the impacts of social risk screening and referrals for Medicare and Medicaid beneficiaries in 29 sites across the country through the Accountable Health Communities model, and in early 2021, it provided guidance to states to encourage the adoption of strategies to address social risk for Medicaid and Children's Health Insurance Program beneficiaries. Increased flexibility to support social services under Medicare Advantage and many state Medicaid programs is also facilitating the expansion of social care. A 2019 report from the National Academies of Sciences, Engineering, and Medicine identified numerous strategies to better integrate social care into health care. In a 2017–2018 nationally representative survey, 67% of practices and 92% of hospitals were screening some of their patients for at least 1 of 5 core social risks. Interest in and the use of social care strategies is likely to have only grown during the coronavirus disease 2019 (COVID-19) pandemic, which both revealed and exacerbated the associations between social factors and health.