ACP: Healthcare Needs Better Patient Care Access, SDOH Programs
A leading physicians' group has advocated for a health industry overhaul, leading with improved patient care access and support for SDOH.
Source: Thinkstock
- Addressing the social determinants of health (SDOH) and boosting patient access to care is one of three key strategies for retooling healthcare in America, according to a new call to action from the American College of Physicians.
The call to action issued by the second-largest physicians’ organization in the country called for some pretty groundbreaking reforms that could upend the healthcare system, a change that ACP said is vastly needed.
In addition to addressing care access barriers and the social determinants of health, ACP advocated for a single-payer system or public option as well as payment system reform.
“ACP set out to develop this new vision for health care by asking, ‘What would a better health care system for all Americans look like?” Robert M. McLean, MD, MACP, president of ACP, said in a statement.
“We believe that American health care costs too much; leaves too many behind without affordable coverage; creates incentives that are misaligned with patients’ interests; undervalues primary care and under invests in public health; spending too much on administration at the expense of patient care; and fosters barriers to care for and discrimination against vulnerable individuals.”
READ MORE: Who Are the Key Players in Social Determinants of Health Strategy?
In its paper on the social determinants of health, published in the Annals of Internal Medicine alongside companion papers about single-payer and public options and other payment reforms, ACP outlined the key social barriers the industry must face in order to facilitate patient access to care.
“It is essential that the U.S. health system goes beyond ensuring coverage, efficient delivery systems, and affordability because financial barriers are not the only barriers patients face,” the group wrote.
As a matter of fact, previous reports have found that more Americans face social challenges accessing care than they do financial challenges.
Social barriers can include race or ethnicity, English language proficiency, location, access to transportation, sexual orientation, immigration status, intellectual or physical disability, incarceration status, religion or culture, socioeconomic status, or patient health literacy.
That’s not to mention the public health issues that ail America: firearms-related deaths, food scarcity, homelessness or housing insecurity, substance use disorders, and maternal mortality are all significant challenges that impede individuals’ ability to achieve wellness.
READ MORE: Racial Health Disparities Limit Timely Patient Access to Care
Through the convening of its Health and Public Policy Committee, ACP developed a set of recommendations for addressing both the access to care and public health challenges that hamper patient wellness across the country.
Foremost, health policymakers must create programs that support patient access to care for particularly high-risk populations, like those that may fall into any of the categories listed above. These programs must make special consideration for the unique needs of populations living in geographically remote locations or in inner-city and traditionally low-income areas.
Special considerations may also be made for aging patient populations, those who are members of the LGBTQIA community, and those with specific religious or cultural beliefs (although moral exemptions for vaccinations should be limited for the good of public health).
Next, the nation must address physician shortages, especially in rural areas or among certain specialties like primary care where a shortage is already quelling care access.
“Integrated actions are needed to address the barriers to physicians, including internal medicine specialists, from entering and remaining in the primary care workforce and practicing in underserved communities,” ACP wrote. “Research and policies to address the impact of hospital closures on access and outcomes of care are urgently needed.”
READ MORE: Patient Access to Care, SDOH Priorities for Hispanic Communities
To that end, policymakers should also examine workforce distribution, meaning surplus providers in certain areas compared to significant deserts in others.
Third, ACP called for a stronger public health infrastructure, such as better funding for research and intervention.
“Supportive public policies that address environmental, geographic, occupational, educational, and nutritional social determinants of health should be implemented to reduce health disparities and promote health equity,” ACP said.
The organization similarly called for better funding for certain public health aims such as smoking cessation, treatment for substance use disorder, programs to address maternal mortality, work to reduce firearms-related injury and death, and interventions to improve access to nutritious food.
Environmental health and attention to climate change also had its moment in the policy paper, with ACP calling it an “immediate, grave, and growing threat.” Natural disasters and certain other environmental elements, like air quality, have an immediate impact on health quality, ACP explained.
These action items come as a part of ACP’s commitment to not just improving healthcare, but overall health and wellness, too.
“Moving forward, policies and interventions must consider these numerous barriers and strive to eliminate disparities,” ACP concluded. “Careful consideration must also be given to environmental health, climate change, nutrition, tobacco use, substance use disorders, maternal mortality, and firearm injuries and deaths, which can also hinder achievement of good health.”


