Over the last 50 years, dramatic breakthroughs in nearly every aspect of health care have occurred, resulting in superior diagnosis and treatments that have saved and prolonged countless lives.
Remarkable new technologies, specialized training and innovation in research and pharmacology have produced better outcomes for almost everyone suffering health challenges. Major advances have also been made in preventive medicine, encouraging such things as exercise and healthy diets.
Utah has been especially blessed to have world-class health care professionals, facilities and systems that provide the best health care, at the lowest costs, of anywhere in the country.
However, one important opportunity to improve health outcomes has, for the most part, eluded the efforts of the health care industry. It has to do with the “social determinants of health.” A great deal of research has shown that the social environments in which we live — including where we live, employment, income, education, family stability, environment and a wide variety of behaviors — impact health much more than clinical care.
In fact, research shows that clinical care accounts for only about 20 percent of one’s health status; genetics account for another 20 percent, while social determinants account for 60 percent. Clearly, if we can address the social needs of health care consumers, we can reduce illness and disease, and greatly reduce health care costs.
Of course, taking some responsibility for social issues impacting individuals and communities is a big step outside the usual role of health care providers. Doctors and administrators who treat patients and run hospitals obviously can’t be responsible for a patient’s living conditions, family stability or employment.
And yet, with social determinants accounting for 60 percent of health status, while 90 percent of health care dollars are spent on clinical care, taking the next big step in improving health care outcomes will certainly require addressing these social issues.
For all of those reasons, Intermountain Healthcare, on whose volunteer board I serve as immediate past chair, has decided to undertake an important and unprecedented pilot project to engage health care providers in collaboration with other key stakeholders to improve health care outcomes by addressing social determinants.
Intermountain President and CEO Dr. Marc Harrison has noted that this is potentially a “transformative” project, but it is stepping into a new arena, and success is not assured.
Obviously, numerous government agencies and nonprofit groups already focus on helping people with the difficult challenges in their lives. But because most of these agencies and nonprofits are not thinking about health as they work with clients, bringing a health care perspective to these interventions and services can help improve lives and establish better health habits.
Intermountain has budgeted $12 million in a collaborative effort called The Utah Alliance for the Determinants of Health. The partnership with several public and private stakeholders will seek improved cooperation between community health centers, other social services agencies and traditional health care providers. It will also seek to better identify and analyze non-medical factors that affect health.
The project will start in Ogden and St. George, attempting to more thoroughly integrate and bolster medical and social services for about 7,500 Medicaid patients. The cost will be $2 million per year in each of those areas from 2019 to 2021. Results will be carefully monitored and evaluated.
Gov. Gary Herbert has appointed Lt. Gov. Spencer Cox to represent state government on the alliance and to coordinate state agency involvement. Organizations such as Weber Human Services, United Way and the Leavitt Partners health care consulting firm will also participate.
This project is being encouraged by top officials of the U.S. Department of Health & Human Services, and will be the subject of a symposium with national health care leaders later this month.
If successful, the project could be replicated throughout Utah and nationally. It could result in more healthy and productive workers for Utah businesses and lower health care costs and insurance premiums.