Primary Submission Category: Health care/services
Comparison of Three Social Needs Screeners’ Performance and Patient Preference
Authors: Kayla Fennelly, Alessandra Calvo-Friedman, Jenifer Clapp, Julie Hyppolite, Rachel Massar, Nichola Davis, Carolyn Berry,
Presenting Author: Lorraine Kwok*
A standardized practice of social needs screening and referrals has been in place at New York City Health + Hospitals (NYC H+H), the largest urban safety net system in the US, since 2017. H+H uses a customized screening tool that is fully integrated into its EHR, developed with input from an expert panel and after review of other screeners. However, recent guidelines from New York State require the use of a version of the Accountable Health Communities (AHC) tool to qualify for reimbursement of social needs screening of Medicaid participants and to unlock access to resources for Medicaid participants. This study compared the performance of and patient preference for NYC H+H’s social needs screener to the New York State (NYS) version of the AHC screener as well as the WellRx tool, another widely used screener, to assess and compare their capture of social needs amongst the same patients. Two H+H primary care clinics provided data for analysis from a convenience sample of 100 patients who completed an H+H screener and one of the alternate screeners during May-June 2024 (50 patients completed the WellRx screener and 50 completed the NYS AHC screener). Analysis of screener results compared rates of needs detected,number and types of needs identified, and patient screener preference. The H+H screener performed similarly to both alternate screeners in identifying patients with social needs, (κ=.7, p<.001 and κ=.6, p<.001). The number of positive items identified by each screener was virtually identical. Patients preferred the H+H screener to the alternates, although the preference was not statistically significant. Despite differences in question phrasing and response options, all three screeners performed similarly. We conclude that requirements for social needs screening can allow for flexibility in choice of screeners as our findings strongly suggest that screeners can vary in phrasing and structure without compromising performance in identifying social needs.