This study aimed to evaluate whether a screening assessment tool that identifies medical and social risk factors is predictive of healthcare costs in the absence of claims data and to evaluate the effectiveness of screening for social factors to target high cost beneficiaries. A retrospective study evaluating medical and pharmacy claims costs for newly-eligible Medicaid adults a year after the behavioral and social risk assessment was performed. Analysis showed that social risk factors lead to an increase in healthcare cost and utilization even after controlling for past hospital utilization, chronic conditions, age, and gender. Managed care networks should routinely screen for social factors to target at-risk patients to better manage long-term healthcare costs.
Tags: Addressing social determinants of health , Building the business case , Publicly Available