Concordance Between Social Needs Screening and Availability of Associated Programs in U.S. Hospitals

This study assessed the extent to which rural hospitals screen for social needs, a previous quality measure in Medicare hospital payment, and evaluated the level of alignment (hereafter referred to as concordance) between hospitals that perform these screenings and the availability of corresponding programs in their community to address these needs. It also examines this concordance by ownership type, region, and Accountable Care Organization (ACO) participation.

Key Findings:

• The analysis found that Critical Access Hospitals (CAHs) had significantly lower concordance between social needs screening and the presence of programs to meet those needs when compared to both urban and rural Prospective Payment System (PPS) hospitals. This trend was observed across various types of social needs such as employment/income support, utility assistance, housing services, and programs addressing interpersonal violence.
• Non-profit hospitals demonstrated the highest prevalence of social needs screening across all ownership types. Urban PPS non-profit hospitals reported the highest levels of screening, followed closely by rural PPS hospitals and CAHs.
• Hospitals that were part of ACOs showed notably higher availability of programs to address social needs compared to non-participants. This was especially evident for services addressing employment/income, housing, education, and social isolation, indicating that participation in ACOs by hospitals may be linked to greater support for social needs.