'Inflated expectations': Hospital, insurer social programs lag in results


Hospitals and insurers have prioritized social determinants of health programs that aim to increase accessibility through transportation and housing initiatives — but it's unclear whether the programs improve health and lower medical costs, according to Kaiser Health News.

Four things to know:

1. Several academic studies have found that while investments in early life, income support and health insurance interventions can lead to health benefits, many analyses of social determinants of health programs "were underpowered to detect health outcomes," according to The Milbank Quarterly.

2. For example, a program giving Medicaid patients one free ride to Philadelphia-based University of Pennsylvania Health System clinics didn't lower patients' 36 percent no-show rate, according to a 2018 study of 786 Medicaid patients. A subsequent study found that some of the patients saved the free ride for a more important appointment or used a different travel method, according to KHN.

3. Even when results from social determinants of health programs are positive, often only a small number of patients benefit from the initiative, according to the report. Additionally, studies sometimes don't run long enough to capture results.

4. "We are probably at a peak of inflated expectations, and it is incumbent on us to find the innovations that really work," Laura Gottlieb, MD, director of the UCSF social interventions research and evaluation Network, told KHN. "Yes, there's a lot of hype, and not all of these interventions will have staying power."

Read the full report here.

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