Evidence on Screening for Social and Economic Needs in Health Care


The health care sector increasingly recognizes the importance of identifying and addressing patients' social needs where patients receive their care. Still, standardized screening for risk factors like unstable housing and food insecurity has not become a routine part of health care visits. Many providers lack information needed to assess and select appropriate screening tools, while others have concerns about incorporating assessments into clinic workflows or about how receptive to screening patients will be. Through its Accountable Health Communities Model, the Center for Medicare and Medicaid Innovation is seeking to address health-related social needs. But the screening tool developed for this national initiative has yet to be tested in a health care setting. This project aims to develop guidance on best practices for assessing patients' social needs, particularly in primary care settings that serve low-income people. A team at the University of California, San Francisco, will create a provider-friendly guide to assist primary care practices with selecting and deploying tools for evaluating their patients' social service needs. Project staff will summarize and compare up to 10 screening instruments based on the social-needs domains they cover, their validity, their acceptability to providers and patients, and feasibility of implementation. They will also interview health care providers about their experiences using the screening instruments. The project team will next conduct a mixed-methods study of the Accountable Health Communities Model's screening tool to assess its effectiveness in identifying social and economic needs and to evaluate patients' responses. Project staff will survey more than 1,000 patients at 10 clinical sites across the U.S. and interview 50 patients. The primary audiences for this research are providers and health system leaders with an interest in identifying screening tools that are most appropriate for their patient populations and care settings. Findings will also inform policymakers and researchers about the feasibility and validity of screening for social and economic needs in the U.S. health care system.

Grant Details

Grantee Organization:
Regents of the University of California
Principal Investigator:
Laura Gottlieb, M.D., M.P.H.
Award Amount:
Approval Date:
November 14, 2017

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