Addressing non-medical circumstances such as a patient’s access to stable housing, nutritious food, and transportation to medical appointments or pharmacies is important for improving health outcomes and promoting smarter spending. Addressing persistent health care inequalities based on race, gender, ethnicity, geography, and other characteristics through health system transformation is also critical for achieving these goals. Together, social determinants of health and discrimination impact patients’ ability to access and participate in care, receive appropriate care, and follow a provider’s advice for treatment and continued care. Because of this, payers and providers need to understand drivers of inequities as well as the overall contexts in which their patients live. This includes information on patients’ home and community environments, their available opportunities to make healthy and safe choices, and their knowledge of the resources available within a patient’s community to support their health and care.
This also requires that payers and providers understand and attend to the extent to which their own institutions may be perpetuating inequities. There is now increased attention to the potential of APMs to support provider and payer efforts to address underlying drivers of health inequities. As new models considering these complex sets of issues are considered, payers and providers must grapple with how to collect and act on different sets of information. In doing so, they must be sensitive to legitimate patient and community concerns related to collecting and using new forms of information and must ensure they continue to be responsive to patient preferences for care. This session will highlight (1) the potential for APMs to provide flexibility and incentives to providers to address the many social determinants of health, including access to housing, opportunities for healthy choices, institutional discrimination, and other underlying drivers of equity/inequity; (2) opportunities for APMs to support delivery system transformation to reduce health inequities; and (3) the importance of surfacing patient and community perspectives and expectations related to the incorporation of social determinants and principles of health equity into ongoing delivery system transformation efforts.