Visibility into psychosocial and mental health factors – and the influence they have on work-related injury and recovery – continues to be a key area of focus for workers’ compensation stakeholders.
More than a third of respondents to the Workers’ Compensation Industry Insights Survey, conducted by Healthesystems in partnership with Risk & Insurance®, identified psychosocial factors as a barrier to injured worker recovery. And respondents as a whole ranked psychosocial factors and/or social determinants of health as the #3 component of workers’ comp claims management into which they want more visibility.1
While a significant component of psychosocial factors includes psychological factors such as anxiety, fear avoidance, catastrophizing, or depression, perhaps even more nuanced are the social components – the factors that aren’t defined in the DSM-5, that don’t have an ICD-10 code, and which can’t be addressed through medical treatment.
In our Social Determinants of Health Article Series, Healthesystems will spotlight several SDoH that impact injury and recovery, with a goal of answering these questions:
- What are social determinants of health (SDoH)?
- How do SDoH intersect with management of the injured worker?
- What are some specific examples of how SDoH can impact workplace injury and its recovery?
- How can workers’ compensation stakeholders gain more visibility into SDoH among injured worker populations?
Social Barriers to Recovery
Social determinants of health, as defined by government organizations including the Centers for Disease Control and Prevention2 and the U.S. Office of Disease Prevention and Health Promotion,3 are the conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes. More broadly, this is inclusive of factors such as access to quality healthcare and education, economic stability, social and community dynamics, and an individual’s environment.
While we have long been aware of SDoH, there has been a continued increasing focus on them, and specifically efforts toward incorporating strategies that measure and address them in the broader healthcare ecosystem.
In early 2021, the Centers for Medicare & Medicaid Services (CMS) issued guidance to states on adopting strategies that address social determinants of health in the Medicaid and Children’s Health Insurance Program (CHIP).4 In February of 2022, CMS also began soliciting feedback on SDoH-related measurement concepts to include the development of a Health Equity Index as an enhancement to the Part C and D Star Ratings program, as well as a measure to determine how well plans are screening members for health-related social needs like food, housing and transportation needs.5
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