Working with ACOs to address social determinants of health

Social, behavioral, and economic factors are important determinants of health and health outcomes. Many health care organizations are beginning to assess the social risks of their patients and facilitate interventions to address health-related social needs. Improving the integration of medical and social services is also central to the Biden administration’s health policy agenda. Organizations participating in payment models in which they are responsible for managing the total cost of care for assigned or enrolled populations, such as accountable care organizations (ACOs), may be particularly interested in integrating medical and social services.

A recent study by Genevra F. Murray and colleagues examined 22 ACOs that were early adopters of initiatives to address the social determinants of heath (SDOH). The study, based on interviews conducted in 2015–18, concluded that despite strong interest, these organizations encountered significant difficulties integrating medical and social services. The principal challenges included: lack of data on their patient’s social needs and the capabilities of potential community partners; lack of mature partnerships between ACOs and community-based organizations (CBOs); and difficulty determining how to assess the return on investment of this work.