You probably cringe when you see reports showing that Americans aren’t getting any healthier for the $3 trillion currently being spent on care. Reasons behind the weak return on investment include all the usual suspects: waste, poor patient engagement, administrative burdens, etc.

Yet, this year’s loudest call to action has centered on the non-medical factors collectively known as social determinants of health (SDOH). How ironic that healthcare stakeholders are urgently investing in something that isn’t even care at all, at least not in the traditional sense.

[Related reading: Payers Accelerate Investment to Close SDOH Gaps]

But investment is clearly necessary. Today’s most incredible feats of modern medicine are being unraveled by the countervailing forces of SDOH. The value of patient care is being squashed by everyday problems with housing, nutrition, transportation, and social isolation, just to name a few.

A recent report from PwC notes that this struggle is not unique to the United States. Worldwide, most of the developed countries are spending more on care while the issues caused by SDOH continue to escalate. Inaction will incur the greatest cost of all, so health leaders must act immediately, the authors say. (PwC)

They recommend five steps to address SDOH:

  1. Build the collective will to address root causes
  2. Develop standard but adaptable frameworks
  3. Generate data insights to inform decision making
  4. Engage and reflect the community
  5. Measure and redeploy to improve strategies over time

We absolutely agree that these are all important factors in shifting the dynamics of healthcare delivery, but what stands out most to us in this list is the opportunity to leverage data insights. As we’ve said before, healthcare still lags behind other industries in digital maturity. Now is a great time for serious investment.

And we believe the biggest impact on SDOH will come from predictive analytics gained from artificial intelligence (AI) tools.

[Related reading: Five of Our Favorite Healthcare Innovations]

A recent OptumIQ survey found that 62% of healthcare industry leaders say that they have a strategy to adopt AI. Among the respondents, 55% of hospitals and 52% of health plans anticipate a return on investment within three years. However, AI applications are more likely to be deployed for administrative tasks rather than clinical support. Opportunities abound. (Optum)

With a sophisticated AI data crunch, stakeholders will be able to anticipate a community’s future needs for medical care and social supports. The result? Earlier, less costly interventions as well as less time and money spent on guesswork.

Imagine a health plan being able to simulate a distinct member population and use AI to test out the impact of, for example, a healthy food home-delivery program versus a program that offers free rides to the grocery store. AI can do that. Imagine a hospital discovering which individual patients need proactive outreach to minimize post-surgical infections. AI can do that, too.

Our Take: To truly reap the better outcomes and cost savings of holistic care, stakeholders need to dive deeply into addressing SDOH by using the predictive power of AI. Those who can go beyond the traditional notion of healthcare and concentrate on the total health picture at scale will succeed in the Smart Health Market.