title: Health systems tackling social determinants of health: promises, pitfalls, and opportunities of current policies.
abstract: Although improving the quality and delivery of clinical care is a critical mission for health systems, they are increasingly being tasked with improving the overall health of patients. This new directive is reflected in the growing number of health sector efforts in population health-a concept intertwined with social forces that impact patient care and health outcomes: the social determinants of health. Three policies that have the potential to help health systems intervene on social determinants of health are: 1) the Internal Revenue Service-mandated Community Health Needs Assessment for nonprofit hospitals, 2) value-based payment reform, and 3) CMS' Accountable Health Communities program. We discuss how these policies fall short of improving the overall health of patients because they ask health systems to play a passive role when it comes to social determinants of health. To mitigate the impact of social determinants, the health sector must lead efforts to address the health-related social needs of patients. A major step forward will involve revising these current policies to support direct, healthcare driven interventions targeting social determinants.
authors.affiliation: The VA Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania, 423 Guardian Dr, 13th Fl, Blockley Hall, Philadelphia, PA 19104. E-mail: kchai@mail.med.upenn.edu.
authors.forename: Krisda H
authors.initials: KH
authors.lastname: Chaiyachati
authors.forename: David T
authors.initials: DT
authors.lastname: Grande
authors.forename: Jaya
authors.initials: J
authors.lastname: Aysola
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006291:Health Policy / Q000639:trends*; D006801:Humans; D008297:Male; D011050:Policy Making; D015397:Program Evaluation; D011787:Quality of Health Care; D064890:Social Determinants of Health; D014481:United States