Identifying Social Determinants of Health

Title

Identifying Social Determinants of Health

Description

Percent of patients in the pharmacy that have documented SDOH data elements.

A higher score is better

Rationale

Pharmacies are often identifying and resolving social determinant of health barriers for patients. However, documentation is vital to showing progress on care. This measure evaluates if a pharmacy is collecting SDOH identifiers at the pharmacy. Once patients are identified, pharmacies will be able to make interventions and bill for these services.

Logic Model

This measure ensures pharmacies are documenting and collecting the data required for SDOH clinical services.

Level of Analysis

Pharmacy (Patient)

Data Source

Pharmacy Data

Denominator Statement

All patients within a pharmacy

Denominator Calculation

1.     1. Identify all prescriptions in a measurement year

2.    2. Identify all unique patients from the prescriptions

3.    3. Apply exclusions

Denominator Exclusions

Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)

Denominator Exclusion Rationale

Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.

Numerator Statement

Patients from the denominator with documented SDOH data elements, including: Insurance Status, Education level, Race, Ethnicity, Zip Code

Numerator Calculation

1.     Identify individuals from the denominator with a documented SDOH data element (composite)

Seguridad Measure Specification Process

Data Stratification

The measure rate will be reported as a percent of patients within a single pharmacy.

If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care).

If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate).

Risk adjustment will be applied when available.

Value Sets

No value set is required for this measure.

Future Iterations

Many pharmacy measures are designed as structure or process. Future goals of this measure will be to track additional SDOH data elements, like housing or food insecurity, for eventual Z-code billing and interventions.

Harmonization¹

Payors: N/A

Providers: N/A