Social determinants of health (SDoH) factors often take a financial toll on patients, making it more difficult for them to afford and access the care that they often need to overcome some of those same SDoH issues.
While providers certainly can't wave a magic wand and make their patients' SDoH struggles disappear, they can take a few concrete steps to help these patients pay for important care.
Improved SDoH, Improved Outcomes
SDoH are defined as "the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks," according to the U.S. Department of Health and Human Services (HHS).
SDoH influence many health-related social needs, including financial strain, housing instability and poor quality, food insecurity, lack of access to health care, and inadequate educational opportunities. Americans who experience SDoH face higher risks of exacerbating health conditions like heart disease, stroke, depression, cancer, and diabetes, according to the U.S. Playbook to Address Social Determinants of Health.
To cite just one example of the many negative consequences of a common SDoH, food insecurity, is associated with a 15% increased risk of having a chronic illness, twice the odds of having mental health issues in mothers and behavioral issues in children, and 58% increased risk of death from any cause, according to HHS.
Conversely, research has shown that interventions to address SDoH can improve health outcomes. For example, offering rides to patients experiencing transportation insecurity enables them to access in-office healthcare they might not otherwise have been able to obtain.
Ways to Adapt to Patients Ability to Pay
"Financial health" is a comprehensive assessment of resources that includes the ability to meet basic needs and encompasses opportunities to save and build wealth, according to the Drexel University Center for Hunger-Free Communities. Financial health is in itself an SDoH that is directly related to housing, food, and energy insecurity, andhas been identified as a root cause of these economic hardships.
Though providers often lack the resources to solve patients' SDoH on their own, they can adopt the following tools that make it easier for these patients to pay their medical bills, which may at least lessen some of the burdens associated with SDoH.
Adjustable payment plans: For some patients, access to payment plans can be a significant help in addressing financial strain. Instead of paying for the entire cost of care upfront, payment plans give patients the ability to pay for care over a predetermined time period. This can provide relief and allow for currently available resources to be used towards things like food and transportation.
From the provider's perspective, offering payment plans is an important consideration towards enabling patients to pay unexpected expenses over time and access care that may otherwise be unaffordable. Payment plans also increase the likelihood that providers will eventually be able to collect payment for the delivery of services that are not fully covered by insurance.
Pre-service check-ins and price transparency: For pre-service check-ins, patients are sent a message in their preferred channel containing a link that confirms several key pieces of data: demographic information, insurance and benefits coverage, copay, and service amount estimates based on visit type. Helping patients understand what they will owe for medical care can help them coordinate care and payment ability with the provider in advance and adjust their own budget as needed.
Modern payment methods: Today's consumers expect flexibility in payment methods when shopping online or with retailers. These expectations are increasingly extending toward healthcare providers. Accordingly, providers should embrace modern payment methods such as digital wallets, cards on file, and peer-to-peer payments to accommodate growing consumer preferences towards these payment approaches. Further, digital wallet services such as PayPal and Venmo do not require users to have bank accounts, making them potentially desirable options for "unbanked" patients.
Offering patients flexible payment plans, pre-service cost estimates, and next-generation payment methods won't eliminate SDoH issues. However, by offering these tools, providers can do their parts to help make it a little more manageable for their patients.
About Ryne Natzke
As Chief Revenue Officer at TrustCommerce, Ryne Natzke is responsible for managing the integrated health and payments strategy and largest, strategic accounts across our key verticals, including both large merchants and software partners. Previously, he worked with early-stage digital health companies at HealthX Ventures and managed partnerships at Epic.