Revising the Logic Model Behind Health Care’s Social Care Investments

Early View Perspective
Integrated care Social determinants of health

Policy Points:

  • This article summarizes recent evidence on how increased awareness of patients’ social conditions in the health care sector may influence health and health care utilization outcomes.
  • Using this evidence, we propose a more expansive logic model to explain the impacts of social care programs and inform future social care program investments and evaluations.

Over the last decade, health care sector activities related to identifying and addressing patients’ social drivers of health have graduated from being innovative and leading-edge practices to being norms and expectations. Key examples include policies from health care payers and professional standard–setting organizations—including the Centers for Medicare and Medicaid Services (CMS), the National Committee for Quality Assurance, and The Joint Commission—signaling that standardized social risk screening and, in some cases, navigation to social services, are now considered a basic standard of care.1 The emergence of these and other state and federal health care standards, regulations, and quality measures related to social drivers of health2 stems from strong and compelling evidence linking social adversity with poor health outcomes3-8 and increasingly leverages the health care sector’s adoption of value-based payment models that reward quality over quantity of services.9, 10


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Gottlieb LM, Hessler D, Wing H, Gonzalez-Rocha A, Cartier Y, Fichtenberg C. Revising the Logic Model Behind Health Care's Social Care Investments. Milbank Q. 2024;102(2):0125.