Improvement of a health care system in crisis starts with addressing drivers of health

The current health care landscape in the United States has reached a critical tipping point.

The practice environment is increasingly unsustainable for both physicians and patients, with physician well-being critically low and the health of individuals across the U.S. in crisis. Despite our nation’s substantial investment in health care — surpassing that of other high-income countries — we continue to face a dangerous lack of support for primary care, significant barriers to patient access and persistent health disparities. These issues collectively exert a profoundly negative impact on health outcomes.

Importance of DOH

To truly transform our health care system and improve patient outcomes while managing costs, it is imperative to recognize that health care extends beyond the confines of a hospital or doctor’s office. The Physicians Foundation’s survey findings underscore this necessity: Nearly all physicians report that their patients’ health outcomes are influenced by one or more drivers of health (DOH), including food security, housing stability, transportation access, utilities access and interpersonal safety. Furthermore, eight in 10 physicians said they believe that the U.S. cannot improve health outcomes or reduce health care costs without addressing these critical factors.

Primary care physicians have an especially important role, as they may see their patients on a more regular basis than other physicians, are often their first point of contact within a health care system and focus on disease prevention. However, we must acknowledge the challenges physicians face in this endeavor. Many report they feel overwhelmed by the task of addressing DOH. While nine in 10 physicians express a desire to tackle these issues, six in 10 report having little to no time or ability to do so effectively.

Our health care system must commit to support efforts to recognize and address DOH. This commitment will be crucial as we continue to strive to meet our patients’ needs with high-quality, cost-effective care.

Tackling DOH initiatives head-on

The Physicians Foundation has been on the vanguard of recognizing and acting on the challenges of DOH on patients and physicians for more than a decade. As part of these efforts, the Foundation proposed comprehensive practical recommendations — Improving America’s Health Care System: Recognize the Realities of Patients’ Lives and Invest in Addressing Drivers of Health — which focus on how to address DOH in how we pay for and deliver care to improve health while reducing costs and easing administrative burdens on physicians.

Additionally, on a national scale, The Physicians Foundation developed the first-ever federal measures, with support from the CMS, to address DOH, comprising the implementation of DOH screenings and referrals to community organizations. As a result, CMS released the finalFY23 Hospital Inpatient Prospective Payment Systemrule, thereby adopting the measures, which allow hospitals to better serve patients by providing holistic, quality care. Additionally, both measures were included in CMS’s proposed “Universal Foundation” of quality measures, which aims to streamline measures across the country.

These measures are essential for physicians to identify and address DOH, which, in turn, improve outcomes and reduce health care costs.

Exemplars of DOH solutions

In recognition of excellence in implementing DOH solutions, The Physicians Foundation recently honored Jubril Oyeyemi, MD, founder and CEO of Cherry Hill Free Clinic (CHFC), chief medical officer at Camden Coalition and medical director for Community Health at Virtua Health, with the Dr. Buz Cooper Award for Addressing Drivers of Health. This award highlights the importance of innovative approaches in addressing DOH and supports Oyeyemi’s work in this critical area.

Oyeyemi’s work with CHFC is a prime example of the transformative impact of addressing DOH. CHFC offers primary and specialty care services to uninsured and underinsured individuals throughout southern New Jersey for free. This work was inspired by Oyeyemi’s realization that many patients in traditional health care settings were unable to access preventive care due to their insurance status. This initiative helps reduce risks, lower costs and prevent avoidable negative health outcomes. His approach is not just about treating medical conditions, but also about understanding and mitigating the underlying factors that influence health.

Furthermore, with Oyeyemi’s groundbreaking Healthy Neighbor 2.0 program, CHFC is making enormous strides to improve outcomes for individuals with type 2 diabetes. Type 2 diabetes is not just a medical condition; it is deeply intertwined with DOH, such as access to nutritious food, safe housing, employment and more. Recognizing this, the Healthy Neighbor 2.0 program takes into account both medical needs and DOH to provide the best care for patients, improving their health outcomes and overall well-being.

The results of this program are already surpassing expectations. Patients at CHFC achieve an average reduction of 1.9 percentage points in HbA1c levels, which measure the average amount of sugar in blood over the past 3 months, after just five visits, significantly above industry standards. The secret to this success lies in time and empathy — each visit lasts more than 30 minutes, allowing physicians and health care teams to delve into DOH affecting patients’ lives.

This initiative leverages the expertise of trusted community health workers, PCPs and prescription cost assistance. By integrating these resources with existing community lifestyle modification interventions, CHFC is creating a robust network of support for individuals at high risk for or living with type 2 diabetes.

This holistic approach serves as a model for physicians nationwide, demonstrating that addressing DOH is not only possible but essential for achieving equitable and effective health care.

Creating solutions to advance health care

Let us rally together — physicians, policymakers, community leaders and individuals — to champion solutions that address the root causes of health outcomes and disparities. Together, we can make great strides to improve health for every person in the U.S.

Reference:

The Physicians Foundation. 2024 survey of America’s current and future physicians. Available at: https://physiciansfoundation.org/wp-content/uploads/2024-Survey-of-Americas-Current-and-Future-Physicians.pdf. Accessed Dec. 11, 2024.