Financing health care system interventions addressing social risks

Social determinants of health affect the distribution of individual-level social risks to health, such as food insecurity, housing instability, and inadequate transportation.¹ Social risks worsen health, health care utilization, and health care costs. For these reasons, those in the health care system are increasingly seeking to help with social risks, often by working with social services agencies and community-based organizations—a strategy called multisector collaboration. Such assistance includes providing food through “food pharmacies” and meal delivery services, supportive housing programs, and nonemergency medical transportation. Although such work is promising, health care–involved social risk interventions frequently contain 2 unstated assumptions: that health care involvement is uniformly beneficial, and that such involvement should be financed by increasing capitated payments for those at greater social risk. In this Viewpoint, we discuss these assumptions, the benefits and drawbacks of health care’s involvement in social risk interventions, and proposals to finance such involvement.