Penn State – WellSpan Health Connection
“We can’t afford not to do it”: One Health System’s Early Journey into Addressing Social Determinants of Health
In 2007, the Robert Wood Johnson Foundation (RWJF) launched a nearly 10-year community-based quality improvement effort, Aligning Forces for Quality (AF4Q). RWJF invested $300 million in 16 communities across the country with the goal of aligning local stakeholders to lift the quality of care in those regions. One of the grantee alliances was WellSpan Health (WellSpan), a nonprofit integrated delivery system based in York, Pennsylvania. RWJF also contracted with Dr. Dennis Scanlon, Distinguished Professor of Health Policy & Administration and Director, Center for Health Care and Policy Research (CHCPR) at Penn State, to assemble a team of researchers to conduct an independent evaluation of the AF4Q initiative.
After the AF4Q program concluded, RWJF was interested in exploring whether participant communities were positioned to work in the Foundation’s newest priority area, “building a Culture of Health.” Because of the existing AF4Q relationships among RWJF, the health system, and the evaluation team, Dr. Scanlon was invited to partner with WellSpan to develop the case study described below. Over 18 months, the authors (all members of the AF4Q evaluation team) observed conversations and decision-making processes that WellSpan used in its early approach to addressing social determinants of health. In return, they served as an academic resource for research and information gathering for the health system.
Their findings appear in the journal Management in Healthcare.
The growing awareness of the effect that social needs have on patient outcomes is motivating many more hospitals and health systems to address these issues in some way. Like most other health systems in the US, WellSpan is not a participant in a national or regional project focused on social determinants of health (SDH), but has been motivated to act by the national conversation and its own observations about how unmet social needs affect both the health outcomes of its patients and the organization’s bottom line.
This case report provides an insider’s view into the processes, decisions, and realities that influenced WellSpan’s early efforts to address SDH. Lessons learned are highlighted that may be helpful to other hospitals and health systems and their collaborators, including the following: recognize the costs of not addressing the social needs of patients; understand that addressing social determinants of health can happen in myriad ways; recognize that it will take some time for science to catch up to the fast pace of innovation in this area; be realistic about the organization’s capacity; and consider both community need and factors affecting the organization’s bottom line before choosing a strategy.
During the case study partnership, Ann Kunkel and Dianna Benaknin of WellSpan Health participated in CHCPR’s “Ask the Experts” video series hosted by Dennis Scanlon. In the discussion, Kunkel and Benankin highlighted their current focus on the impact of housing on health and described several programs WellSpan created to address avoidable housing-related hospital admissions.
For their work on reducing avoidable housing-related hospital readmissions, WellSpan received the Pennsylvania Hospital and Healthsystem Association’s 2019 “Living the Vision Award.”
Authors: Center for Health Care and Policy Research, Penn State University
Dennis P. Scanlon, Distinguished Professor of Health Policy and Administration; Director, Center for Health Care and Policy Research
Laura J. Wolf, Research Analyst
Bethany Shaw, Research Analyst
Jocelyn M. Vanderbrink, Research Associate
Diane C. Farley, Research Analyst
