During the past three years, we have spoken with leaders of health care and community-based organizations interested in developing partnerships to address social determinants of health for the high-need, high-cost populations they serve. To do so, these leaders need information on what works and the expected impact from investments.
To help in these efforts, the Commonwealth Fund is publishing an updated evidence guide of 80 studies of social needs interventions for adults with complex health and social needs, specifically the impact on health care utilization and costs. The guide is organized into seven sections: housing, home modifications, nutrition, transportation, legal and financial counseling, social isolation and loneliness (new in this edition), and cross-cutting care management programs.
Our focus on health care utilization and cost impact for adults with complex needs is intended to help organizations make a business case for delivering social services. These data can be used as inputs for a Return on Investment (ROI) Calculator to inform program planning and in negotiating financially sustainable contractual relationships. In our work with the ROI Calculator, we learned that decision-makers often lacked benchmarks on program impact and costs, which inspired us to create the evidence guide as a companion resource.
Overall, we continue to see mounting evidence that addressing social needs of complex patients can reduce costly forms of health care utilization and result in savings. More research is being produced in this area, with studies of increasing rigor. Supportive housing for chronically homeless and disabled individuals and nutrition interventions to address food insecurity have been studied extensively, as have care management programs that integrate health care and social services. Evidence on other social need interventions is still in an early stage of development.