Increasingly, providers and payers seek to address social determinants of health (SDoH) in their patient populations to lower utilization costs as value-based care becomes more prevalent. To do so, the providers and payers must engage with organizations capable of affecting changes in aspects of patients’ lives that traditionally existed outside of the scope of healthcare.
This report evaluates these solutions, identifying the strengths and weaknesses of options in the market and predicting how the market will develop in the future. Research in this report is based on interviews with executive leadership teams of solutions vendors, executives from the major EHR companies, and extensive secondary research.
Key Takeaways
- The steady march to value-based care (VBC) amplifies interest in solutions that contribute to utilization management strategies.
- Providers that wish to address patients’ social needs can do so efficiently through referrals to community partners. This is made dramatically easier with community resource engagement solutions.
- Integration with community partners remains the main barrier to implementation, given challenges with data governance. Legal and internal engagement issues also slow adoption.
- The next two years will bring expansion of product capabilities with slow and steady growth in implementation as the market better defines standards for performance. Years three through 5 will see accelerated adoption and growth.
- Within five years, a public option for insurance will dramatically increase the rate of solutions adoption, culminating in >80% adoption in provider locations by 2030.
Table of Contents
Executive Summary
- Key Takeaways
- Inclusion Criteria
- Why Now?
- Use Case
- Challenges
- Trends
1. The State of Solutions Engaging Community Resources
- Terminology, Definitions, and Inclusion Criteria
- The Social Environment
- Social Determinants of Health (SDOH)
- Social Risk Factors
- Behavioral Risk Factors
- Social Needs
- Community Resources
- Why Adopt Solutions That Engage Community Resources Now?
- Addressing Social/Behavioral Risks Shows Promising Results and Roi
- The Capitation of Medicaid and the March to VBC
- The Impact of Covid-19
- Key Stakeholders
- Providers
- Community Partners
- Payers
- Governments
- Patients
- Use Cases and Business Cases
- Use Cases
- Business Case
- Challenges to Adoption
- Community Partner Engagement and Onboarding
- Internal Engagement
- Legal Issues
- How is the Market for Solutions That Engage Community Resources Developing?
- Next Two Years
- Next Five Years
- Next Ten Years
2. Leading Vendors of Solutions That Engage Community Resources
- Completeness of Solution
- Roadmap/Vision
- Market Momentum
- Ability to Execute
3. Vendor Profiles
- Aunt Bertha
- Cerner
- Epic
- Healthec
- Nowpow
- Solera
- Unite US
- Vendors to Watch
- Xealth
- Signify Health
- Healthify
Appendix A: Acronyms Used
About the Authors
Tables and Figures
1. Executive Summary
Figure 1: Benefits of Community Resource Engagement by Stakeholder
Figure 2: Workflows for Community Resource Engagement Solutions
Figure 3: 10-Year Projection for Community Resource Engagement Solutions Adoption and Growth
2. The State of Solutions Engaging Community Resources
Table 1: Report Terminology Definitions
Figure 4: Patient Health Rationale for Connecting Community Partners With Providers
Figure 5: Expansion of Value-Based Reimbursement Programs by State
Figure 6: Workflows for Community Resource Engagement Solutions
Figure 7: Use Case of Sdoh Solution
Figure 8: Expected Roi by Dimension of Social Environment Addressed
Figure 9: 10-Year Projection for Community Resource Engagement Solutions Adoption and Growth
Samples
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Companies Mentioned
- Aunt Bertha
- Cerner
- Epic
- Healthec
- Healthify
- Nowpow
- Signify Health
- Solera
- Unite US
- Xealth
