INTEGRATED CLINICAL AND SOCIAL CARE

Intermountain Healthcare

Together with SelectHealth, Intermountain Healthcare forms a not-for-profit health system committed to helping members and everyone in their communities stay healthy. They share a mission: Helping people live the healthiest lives possible.

In order to locate and refer patients to resources that address social needs, SelectHealth implemented a SDOH screening tool  as a part of its overall strategy.

FOCUS:

Healthcare researchers have long known that social determinants are a major influence on healthcare outcomes and costs. The World Health Organization has described these nonclinical factors as “the conditions in which people are born, grow, live, work and age,” which in turn “are shaped by the distribution of money, power and resources at global, national, and local levels.”

In order to locate and refer patients to resources that address social needs, the healthcare system must have a standardized approach to screen for these conditions and document them. In August 2016, after surveying different tools available, SelectHealth elected to implement the PRAPARE one-question social determinant of health screening as a part of our overall strategy.

SelectHealth piloted the PRAPARE screening in our Care Management program as a part of the member’s initial and ongoing assessments for all lines of business. SelectHealth has analyzed this data to look for trends in unmet needs and build a partnership with United Way 2-1-1 Program to create more effective referrals to community resources. During this process, gaps in services were identified like urgent transportation for Medicaid members. This led to the creation of a pilot program where Care Managers can order a ride for Medicaid members who need urgent care but do not have access to transportation. Work to further expand PRAPARE screenings throughout the Intermountain Healthcare system in clinics, hospitals, and specialty services began in September 2017.

Kaiser Permanente

Kaiser Permanente recognizes the importance of access to health-promoting environments (e.g. work, school, and diverse community settings where people spend much of their time) in addition to working on individual behavior changes to achieve “total health”. Kaiser Permanente utilizes a innovative framework to align its resources to maximize well-being for its beneficiaries and their communities.

FOCUS:

Kaiser Permanente’s innovative framework – “total health” – uses and aligns all its resources to maximize physical, mental, and social well-being for its beneficiaries and the communities in which they live. These resources include sourcing and procurement, workforce pipeline development, training, investment capital, education programs, research, community health initiatives, environmental stewardship, and clinical prevention.

It emphasizes high-impact approaches like workforce wellness initiatives for employers and customers, increases access to healthy foods and physical activities in schools, and reduces Kaiser’s institutional carbon footprint through purchasing green energy. Kaiser also supports local economic development in communities of color through purchasing from women and minority-owned organizations. Kaiser Permanente actively pursues a “values- and mission-guided corporate strategy” in their effort to maximize and support the total health of their members and the communities they serve. The total health framework has three interrelated facets:

  1. Focus on the “whole person” – physical, mental, and spiritual wellbeing
  2. Commitment to deliver the best health care services through its delivery system, with health-promoting community assets integrations (e.g. healthy food, safe housing, transportation, support from community health workers)
  3. Gathering all of Kaiser Permanente’s assets to bear in support of the health of its members

In order to address the social and non-medical needs, Kaiser Permanente also screens patients for unmet social needs and refers them to resources in their communities.