Few hospitals and physician offices screen for five key social needs

Despite increasing recognition of the importance of the social determinants of health, only 24% of hospitals and 16% of physician offices in the U.S. screen for all five social needs prioritized by CMS, according to a new study published in JAMA Network Open.

For the study, researchers asked hospitals and physician offices if they screened for food insecurity, housing instability, utility needs, transportation needs, and experience with interpersonal violence. Screening for interpersonal violence was the most common for both hospitals (75%) and physician offices (56%), followed by screening for transportation needs, while asking about utility needs was the least common.

Most hospitals and physician offices screened for at least one social need, according to the study. However, physician offices were less likely to screen: 33% of physician offices reported no screening compared with 8% of hospitals.

The availability of resources may explain the discrepancy in screening rates between hospitals and physician offices, according to the study’s authors. Physician offices “may lack the financial or staffing resources to routinely screen in the course of clinical care,” they said. “Hospitals may have more resources, including staffing, financial, and technological, as well as more processes, protocols, and standardization in care delivery.”

Hospitals must also adhere to federal regulations on patient safety for their CMS certification, which may explain why they are more likely to screen for social needs, the authors noted.

To increase screening, hospitals and physician offices need financial support, according to the authors. “Payers could allow physicians and hospitals to bill for evidence-based programs, such as FoodRx, that have been shown effective at addressing needs and improving outcomes,” they said. “CMS could consider expanding care management billing to include managing care for patients who are both at risk or have clinically complex conditions in addition to social needs.”