SDOH Program Design, Technology, Data and Evaluation that Drives ROI

Given the complexities of the health- and social care systems, longstanding questions persist about how to integrate health- and social care networks to improve care delivery, patient outcomes and experiences. Measuring social drivers of health can determine how community characteristics impact population health. With this knowledge, organizations can navigate challenges using evaluation and coordination to mitigate health disparities. This requires: cross-sector collaboration to address unmet social needs, and an ability to map resources and results using structured evaluation and data science. This session will discuss best practices in health- and social care network integration, including program design, technology infrastructure and evaluation based on two real-world examples. Florida’s Sarasota Memorial Hospital implemented a maternal health program that resulted in 79 percent reduction in odds of postpartum-related readmission rates and 58 percent reduction in odds of all-cause hospital readmissions. North Carolina’s HRSN Medicaid program realized a $85 per member per month savings in early evaluations.