By Jennifer Polello
Last year may have marked the beginning of social determinants of health (SDoH) finally receiving the attention they deserve for their considerable influence on health outcomes.
Both payers and providers made strides in initiatives incorporating SDoH information into care and treatment plans, recognizing the major role that factors like housing, transportation and food security play in patients' long-term health. In 2020, progress should continue along similar lines, with more investment in projects to help meet the socioeconomic and environmental needs of patients and community members.
Given the impact of SDoH, many healthcare organizations (HCOs) have prioritized establishing partnerships with community organizations to address these issues. However, SDoH can vary considerably between communities. Understanding local resource needs requires capturing and analyzing SDoH data, which can be a challenge for many HCOs.
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As a not-for-profit, provider-owned health plan, Community Health Plan of Washington (CHPW) had experienced frustrations around the limited availability of accurate SDoH data which is critical to understanding and improving health outcomes. The CHPW network includes 20 community health centers (CHCs) that operate more than 130 clinics across the state, about 2,500 primary care providers, 14,000 specialists, and upwards of 100 hospitals. In an effort to better understand its members’ SDoH, address the homelessness crisis prevalent in its community and improve overall health outcomes, CHPW’s leadership launched an initiative to systematically address SDoH challenges across its network.
Better documentation of SDoH by using Z-codes (IDC-10-CM codes)
To effectively understand these challenges, CHPW wanted to leverage a shared analytics platform to assess SDoH issues and track the efficacy of resource allocation and interventions. This meant that we needed to ensure our provider network consistently captured structured SDoH information by logging the information on either a claim or in the electronic health record (EHR), where it would be accessible to our analytics platform.
Essential to this effort were IDC-10-CM Code Categories (often called “Z-codes”) that can be used to capture SDoH. Categories range from education (Z55) to neighborhood and the built environment (Z57) to social and community context (Z60, Z62, Z63, Z65). Because these codes are part of the broader IDC-10 system and could be easily entered on claims, we felt that they were the best way for our network to document SDoH data.