Infographic: Community Health Navigators Address Social Determinants of Health to Impact High Hospital Utilization

Monday, July 29th, 2019
This post was written by Melanie Matthews

AmeriHealth Caritas leverages its community care management teams led by a medical director and consisting of community health navigators, community care managers, and a program manager to engage high- and emerging-risk members to increase their access to care and improve their overall healthcare experience through care management services delivered in member homes, with an emphasis in screening for and addressing social determinants of health (SDOH), according to a new infographic by AmeriHealth Caritas.

The infographic examines AmeriHealth Caritas’ success in identifying and addressing specific SDOH vulnerabilities at both the population and member levels.

Assessing Social Determinants of Health: Screening Tools, Triage and Workflows to Link High-Risk Patients to Community ServicesLeveraging the experience of several physician practices already screening patients for social determinants of health (SDOH), Montefiore Health System recently rolled out a two-tiered assessment program to measure SDOH positivity in its predominantly high-risk, government-insured population.

Assessing Social Determinants of Health: Screening Tools, Triage and Workflows to Link High-Risk Patients to Community Services outlines Montefiore’s approach to identifying SDOH markers such as housing, finances, healthcare access and violence that drive 85 percent of patients” well-being, and then connecting high-need individuals to community-based services. Click here for more information.

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