SDOH in the Anti-DEI Era: The New Call to Action

Payers are facing possible CMS funding cuts to Medicaid waiver programs and possible threats to SDOH data collection.

Recently, HealthLeaders has explored the connection between DEI, healthcare reform, and their intersection point: the social drivers of health (SDOH). In the face of CMS funding cuts to Medicaid waiver programs and possible threats to SDOH data collection, we interviewed Trenor Williams, co-founder and CEO of Socially Determined.

HealthLeaders: What is the state of the SDOH union?

Trenor Williams: Healthcare in the U.S. is egocentric. The average adult only spends about an hour in a given year in an outpatient clinic with either a doctor, nurse practitioner or PA. That means they spend over 524,000 minutes outside of that setting. For those of us in the industry to believe that we know all that we need to about a person based on that the short snippet of time feels egocentric.

When I think about SDOH, I think about all of the rest of that time: people living their lives, the advantages and tools they have, the barriers and challenges they face every single day. Our work in the SDOH space is about insights into those 524,000+ minutes and then connecting that data with the robust healthcare data that is available in order to create a holistic understanding of a person, population or community.

If you're caring for a population — whether you're a provider, health plan, or life sciences company — you want to know as much as you possibly can about them so that the interventions you provide have the best chance of meeting their needs, improving their health outcomes and reducing costs.

HealthLeaders: CMS has cut funding for some Medicaid waiver programs that cover SDOH benefits. What are your stakeholders saying — are they nervous?

Williams: With any changes in the broader funding of healthcare, SDOH initiatives are going to require people to be so much more intentional about the work that they do.

They're going to need to have as much insight and information as they possibly can. They're going to have to be precise with the investments that they make and the actions that they take.

They're not going to have the ability to create a big intervention that is presented to everybody but is only really helpful for a specific group of people.

What the industry wants from us is to be much more focused and targeted — matching needs with interventions that create better outcomes.

HealthLeaders: What aspects of SDOH investment are more likely to stay protected and what qualities do they share that will promote persistence?

Williams: I think that's a great question, and I think it's the right question. Rather than thinking about what goes away and what becomes harder, let’s focus on what actually works? What will stay and what will persist are the areas where we can find really good alignment. I think we all want to reduce fraud and abuse. Within these conversations, we have the opportunity to double down on the stuff that actually works.

HealthLeaders: What are some examples of what works?

Williams: I'll give you two that I think are related.

First, I believe there will be significant opportunities to align ongoing work in the SDOH space with the MAHA.

Make America Healthy Again (MAHA) feels like it's going to be a massive initiative from CMS, HHS, and the Administration overall. I think they’re still flushing out the details but — being the son of a social worker and someone who was a family practice doctor — I'll get on board every day of the week and twice on Sunday with making people healthy.

I would argue that increasing access to the right health care for the right people has a chance to improve outcomes and reduce costs and is integral to making people healthier. This includes getting healthy food to people who have diseases or conditions that are improved with good nutrition (e.g., pregnancy, cancer, recovery, diabetes, heart failure) or providing transportation to people to get them to the doctor so that they don’t need to call an ambulance to go to the ER.  

Second, I think a focus on return on investment (ROI) in SDOH is key.

If I had a call to action around this, it would be to get the right intervention to the right people; broadly define ROI beyond just financial return; measure, measure, measure; and tell everybody the story.