Decoding Social Care: Understanding Available Data Standards
In the evolving landscape of health and social care integration, the ability to effectively communicate impact using data is paramount. For community-based organizations (CBOs) and their partners on the front lines, understanding the language of data is becoming more critical than ever. That’s why we’re eager to guide you through our comprehensive paper on decoding social care: Leveraging Data Standards in the CBO Setting.
Welcome to Part 3 of our Social Care Data Series, where Carla Nelson, Findhelp’s Senior Director of Healthcare and Public Policy, shares foundational knowledge on how social care data standards help clearly demonstrate the value of health-related social needs interventions, secure sustainable social care funding, and enhance healthcare partnerships.
Inside the paper: Your roadmap to understanding social care data standards
Leveraging Data Standards in the CBO Setting is for community-based organizations (CBOs) navigating the integration of social care within broader healthcare frameworks. It unpacks the complexities of social care coding, offering clarity and actionable insights. Here’s a closer look at what you’ll discover:
The critical role for CBOs of coding and documentation in healthcare
Standardized coding is crucial for CBOs seeking to partner with healthcare providers and plans. But coding and claims submission are new territories for CBOs, and it is important for these organizations to recognize that adopting data standards enables them to:
- Accurately document vital services.
- Track and report on client outcomes with precision.
- Align documentation with recognized billing frameworks, which is key for reimbursement.
- Substantiate program effectiveness, enabling sustainable funding and robust reimbursement agreements.
About today’s social care coding systems
Healthcare providers use standardized coding systems to create a common language for documenting and communicating patient information within the complex healthcare system. This standardization allows for seamless information exchange between providers, hospitals, and payers, ensuring that everyone understands the patient’s condition and the services provided. Ultimately, these codes help healthcare organizations track outcomes, improve quality, and receive appropriate reimbursement.
Over the past several years, new codes have been developed as part of healthcare’s coding systems that standardize social care screening, diagnosis, and service delivery information. CBOs participating in Medicaid waiver programs and other initiatives that reimburse CBOs using a healthcare framework will likely need to implement these codes. In practice, these codes come together to provide a robust view of people’s needs and how they are addressed. Below are examples of how these codes are working together today as part of New York’s section 1115 Medicaid waiver.
1
LOINC (Logical Observation Identifiers Names and Codes)
Discover how to use LOINC codes to standardize HRSN screening questions and answers, ensuring consistency in how needs are initially identified. For instance, the paper details how tools like the Accountable Health Communities (AHC) screener use specific LOINC codes for each question-answer pair related to domains like housing or food security.
2
ICD-10 Z Codes
Delve into how these codes from the ICD-10-CM diagnosis system are used to document individual HRSNs—the specific social challenges your clients face (e.g., Z59.0 for homelessness, Z59.41 for food insecurity). Z codes provide invaluable context for health outcomes and are often required for claims.
3
HCPCS and SNOMED-CT
Learn how these systems are used to code the actual social care service delivery. Use HCPCS codes for services like case management or community health worker interventions. SNOMED CT offers a comprehensive vocabulary to describe services and findings in a way that is compatible with electronic health records, such as “Referral to food pantry program.”
Practical and simple application with Findhelp
To support this critical work, Findhelp integrates social care code libraries and mapping functionalities directly into our platform. This allows CBO staff to more easily add standardized codes based on screening and service delivery, and even automate the flow of selected codes to a claim for submission to payers, freeing them to focus on client care.
Why this paper is an essential resource for CBOs
Embracing data standards is a transformative step for any CBO. Read the paper to demystify the process and understand how coding works. The future of social care is data-informed. Equip your organization with the insights to navigate this future successfully.
Bridge health and social care
Our platform provides an integrated and seamless closed-loop referral system that bridges the health and social care sectors. While social care data capabilities improve, organizations can take action now to understand your population’s needs and plan for the future.
Connect with us to learn how your organization can use social care data to identify strategies, make decisions, and assess performance.
