Social Determinants of Health (SDOH)
Social Determinants of Health are nonmedical factors such as housing, income, education, and food access that shape health outcomes. Capturing SDOH data informs risk adjustment, care coordination, and value-based payment arrangements affecting how facilities are reimbursed.
What are Social Determinants of Health (SDOH)?
Social Determinants of Health (SDOH) are the nonmedical conditions in which people live, work, and age that influence their health and well-being. These include factors such as housing stability, income, education, transportation, and access to nutritious food.
Although they fall outside the clinical encounter, these determinants can shape health outcomes as powerfully as medical care itself. A patient's circumstances often affect whether they can follow a treatment plan, attend follow-up visits, or recover successfully.
Why does SDOH data matter for reimbursement and care?
Capturing SDOH information helps care teams coordinate services, anticipate barriers, and connect patients to community resources that influence recovery. It also feeds risk adjustment, allowing payment models to account for populations that face greater social challenges.
In value-based payment arrangements, where reimbursement is tied to outcomes, documenting these factors can directly affect how facilities are evaluated and paid. Recognizing the social context behind a patient's health is increasingly part of both clinical quality and financial performance.
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