Social Need Markers in the ACG System

May 4th, 2022
New and Novel  |  
Population Health Management & Improvement  |  
Social Determinants of Health
Social Need Markers in the ACG System

How You Can Quantify Patient-Level Social Barriers and Facilitate Superior Health Outcomes

Today, we introduce another new and unique feature in the upcoming ACG System v13.0 release: Social Need Markers. As part of the ACG System’s commitment to accurately capturing the impact of social determinants of health, Social Need Markers quantify patient-level social barriers to care. This helps System users understand how often these issues occur and how they impact health and design strategies. Read more to see how you can greatly improve your community’s overall health by using this data.

What Are Social Need Markers?

Social Need Markers (SNMs) are patient-level social needs captured in screening tools or in coded diagnoses. Patients are reporting these needs with increasing frequency, as more people find themselves without steady employment, health insurance or reliable transportation, due to external circumstances. System users can use this data to assign additional resources to patients with these specific needs, and consider common needs when developing their community engagement and partnership strategies.

How Do You Use Social Need Markers?

The ACG System categorizes SNMs into five easy-to-understand domains with known impact on health outcomes. These domains help users see the type of care a disadvantaged population needs most.

Social Need Domains are categories that significantly influence overall patient health. For example, patients may indicate issues with safety, stress, nutrition or other factors as documented challenges that prevent them from effectively managing their health problems. Or, individuals in part of the population may struggle with unsteady employment and cannot afford health services. This information is crucial to providers and care managers, so they can identify each individual’s needs and ensure they are connected to the right resources.

How Do Social Need Markers Help You?

For health care organizations deploying a population health strategy, it’s essential to understand social needs amongst key patient groups. Social Need Markers are used in the ACG System to provide actionable insight and analyses, and to inform planning and program deployment, ultimately resulting in better health outcomes.

This data is invaluable for health care providers and organizations that are frequently held responsible for overall patient health and the total cost of that care. By using these novel features, physicians and hospitals gain a unique view into their patients’ lives that cannot be obtained through other methods.

For more in-depth information on Social Need Markers and the upcoming ACG System v13.0 release, read our overview here.





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