IMPROVING HEALTH OUTCOMES AND LOWERING COSTS: ATTORNEYS AS PROACTIVE, PAID PROVIDERS TREATING SOCIAL DETERMINANTS OF HEALTH

Innovative and emerging value-based delivery models should include attorneys as health care team members to treat the social determinants of health. Social determinants of health ("SDH") are non-medical conditions that can produce or undermine health and include basic human needs like economic status, housing, nutrition, employment, and similar issues. Health care experts increasingly recognize the role that SDH play in driving the cost, utilization, and outcomes of medical treatment. The U.S. Department of Health and Human Services ("HHS") is looking for holistic ways to innovatively manage SDH, including paying for assistance whether or not that assistance involves traditional healthcare services. Private payors and providers are financially incentivized to incorporate SDH management into their treatment plans because new payment models are already penalizing providers for quality measures largely affected by SDH. Attorneys can help "treat" SDH, such as financial distress, home environment (including housing, utility, and food security), employment issues, resolution of insurance / immigration / criminal / military status, and many other SDH. Instead of relying on the goodwill of attorney organizations to provide free legal services to patients, the health care delivery system should include reimbursement mechanisms to pay attorneys for this valuable service. The legal profession and the health care industry will both benefit from the development of payment mechanisms that incentivize attorneys to engage in new roles treating SDH. This Article explores ways that untreated SDH impact health care and how attorneys can add value by embracing advocacy roles for patients, providers, and payors to treat social determinants of health.