Dr Susan Mani Outlines Barriers to Understanding the ROI of SDOH Initiatives

May 31, 2019

Susan Mani, MD, vice president of Clinical Transformation and Ambulatory Quality at LifeBridge Health, discusses barriers to understanding the return on investment of social determinants of health initiatives.

Susan Mani, MD, vice president of Clinical Transformation and Ambulatory Quality at LifeBridge Health, discusses barriers to understanding the return on investment of social determinants of health initiatives.

Transcript

What are some barriers to understanding the return on investment of social determinants of health initiatives?

I think the biggest barrier that we had initially was really trying to figure out how to put dollar amounts to work that we did. Often times in health systems, we’re used to thinking of traditional service lines—cardiology, orthopedics, procedural based, visit based. So, very frequently, it’s easy to use that language. How do you think of it from a population health standpoint or from a care management standpoint? So, we really had to tweak the definition a little bit differently when it came to care coordination events, and once we created that language it became a lot easier to show a return on investment. How well were we actually touching our potential patients? Were our patients tiered?

We were thinking about high risk versus rising risk or low risk, because every patient is not going to need the same intensity of care. And the other thing we started to look at was the intensity of touch. For some of our patients, like our high-risk patients, they’re going to need a lot more intensity of touch, as I call them. For example, in a clinician’s office, you’re thinking about follow-up visits. Well, for our care coordination teams, it might mean those phone calls, it might mean how frequently are they keeping up with the care plan. All of those are actually touch points that you want to quantify. And then what are the referrals to services? Over time, if we have to start thinking about what community resources did we link our patients to, how are we getting them back into primary care successfully so they’re following up with their physicians. All of those are very important when you’re calculating your return on investment because that is the true RVU [relative value unit] in a population health standpoint.