The social factors that leave a “thumb-print” on health status and population health – employment and economic stability, housing, nutrition, and neighborhood context – are fairly well known throughout the health and human service field care industry (see Social Determinants Of Health & Medical Homes and Social Determinants Of Health – How Housing & Other Social Support Services Influence Spending). These social determinants, as they are called, are diverse but tightly interconnected and often boil down to lack of access to care and services.

With the move to value-based reimbursement (in all of its forms), provider stakeholders are taking a greater . . .

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