From Policy to Practice: Assessing the State Innovation Models Initiative’s Early Success in Incorporating Social Determinants of Health in ASCVD Hospitalizations in the United States

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Author(s)Parekh, Tarang
Author(s)Xue, Hong
Author(s)Wadhera, Rishi K.
Author(s)Cheskin, Lawrence J.
Author(s)Cuellar, Alison E.
Date Accessioned2024-08-28T19:18:57Z
Date Available2024-08-28T19:18:57Z
Publication Date2024-08-27
DescriptionThis is a pre-copyedited, author-produced version of an article accepted for publication in American Journal of Epidemiology following peer review. The version of record Tarang Parekh, Hong Xue, Rishi K Wadhera, Lawrence J Cheskin, Alison E Cuellar, From Policy to Practice: Assessing the State Innovation Models Initiative’s Early Success in Incorporating Social Determinants of Health in ASCVD Hospitalizations in the United States, American Journal of Epidemiology, 2024;, kwae313, https://doi.org/10.1093/aje/kwae313 is available online at: https://doi.org/10.1093/aje/kwae313. © The Author(s) 2023. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article will be embargoed until 08/27/2025.
AbstractThe study examines effects of the CMS State Innovation Models(SIM) on capturing social risk factors in adults hospitalized with Atherosclerotic Cardiovascular Disease (ASCVD). Using a difference-in-differences(DID) approach with propensity score weights, the study compared documentation of secondary diagnosis of SDOH/social factors using ICD-9 V codes (“SDOH codes”) in adults hospitalized with ASCVD as a primary diagnosis (N= 1,485,354). Data were gathered from January 1, 2010, to September 30, 2015, covering the period before and after the SIM implementation in October 2013. From January 2010 to September 2015, SDOH codes were infrequently utilized among adults with ASCVD(0.55%, 95% CI: 0.43%-0.67%). SDOH codes with ASCVD increased from pre- to post-period in SIM states(0.56% to 0.93%) and comparison states (0.46% to 0.56%). SIM implementation was associated with greater improvement in SDOH codes utilization (adjusted OR 1.30, 95%CI: 1.18-1.43) during ASCVD hospitalizations. The odds of SDOH codes utilization were 86% higher in ED admissions(AOR 1.86, 95%CI: 1.76-1.97) than in routine admissions with ASCVD. Findings were similar when limiting population to older adults(>=65 years) enrolled in Medicare(AOR 1.50, 95%CI 1.31-1.71), whereas not significant for Medicaid beneficiaries. The study points to challenges for healthcare providers in documenting SDOH in adults with ASCVD.
SponsorAcknowledgments1: During the realization of this work, Tarang Parekh was a summer research fellow, recipient of a Doctoral Research Scholarship, and the High Impact Grant supported by the Office of the Provost, George Mason University. Funding: None Conflict of Interest: None 1 Study investigators, conference presentations, preprint publication information, thanks.
CitationTarang Parekh, Hong Xue, Rishi K Wadhera, Lawrence J Cheskin, Alison E Cuellar, From Policy to Practice: Assessing the State Innovation Models Initiative’s Early Success in Incorporating Social Determinants of Health in ASCVD Hospitalizations in the United States, American Journal of Epidemiology, 2024;, kwae313, https://doi.org/10.1093/aje/kwae313
ISSN1476-6256
URLhttps://udspace.udel.edu/handle/19716/34903
Languageen_US
PublisherAmerican Journal of Epidemiology
Keywordscardiovascular disease
Keywordssocial risk factors
Keywordsstate innovation model
Keywordspayment model
Keywordssocial determinants of health
Keywordsgood health and well-being
Keywordsreduced inequalities
TitleFrom Policy to Practice: Assessing the State Innovation Models Initiative’s Early Success in Incorporating Social Determinants of Health in ASCVD Hospitalizations in the United States
TypeArticle
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