Federal priorities have increased focus on the social factors that play a significant role in health outcomes. Efforts to integrate social determinants of health (SDOH) screening into health care models are ongoing, but a gap has been identified between positive screenings and outpatient referrals for services.[1] Nationally, there is a window of opportunity to build sustainable and beneficial cross sector collaboration. Effectively meeting community needs requires health care professionals and public health leaders to act now, forging improved partnerships with community-based organizations.
Recognizing the significant impact of social determinants of health on achieving health equity, the Centers for Medicare and Medicaid Services agency (CMS) has suggested that all health care organizations and providers integrate SDOH screening and care into their health care models and programs.[2]Other organizations, including the Joint Commission and the Agency for Healthcare Research and Quality (AHRQ), have made similar recommendations to health care organizations. AHRQ further …