Health quality and non-medical factors: a single path to better results

September marks the prelude to a key moment for health plans: the arrival of October, when star ratings are published, assessing the quality of healthcare services. These metrics not only determine financial incentives and reputation, but also reflect, above all, the trust beneficiaries place in their care.

Beyond clinical care

Preparing for these assessments means recognizing that quality in health services goes beyond clinical excellence. Factors such as access to nutritious food, reliable transportation, safe housing, and social support—known as non-medical health factors—have a determining impact on people's health outcomes.

These factors are, in essence, the conditions under which people are born, live, work, and age, directly influencing their well-being. For example, if a patient lacks transportation to attend medical appointments or access to adequate nutrition, their clinical treatment is compromised, no matter how advanced the condition is.

Non-medical factors as the basis of quality

Quality programs, such as Star Ratings, measure metrics that go beyond medical care itself. Medication adherence, prevention and management of chronic conditions, and patient experience all depend on members having the necessary resources and support.

In other words, non-medical factors are the foundation that supports quality metrics. Addressing these needs not only improves members' daily lives, but also increases the likelihood of achieving better assessment results.

How Sociants™ Drives Quality in Community

At Sociants, we believe that quality is built in community. Our platform connects health plans, providers, and community organizations in a single ecosystem, enabling us to identify social needs, effectively coordinate resources, and reduce gaps that affect health outcomes.

Connecting a member with transportation to their medical appointment not only prevents unnecessary hospitalizations but also positively impacts the quality metrics defined by the Star Ratings. Furthermore, addressing non-medical factors with Sociants translates into concrete benefits for plans: lower hospitalization costs, greater member satisfaction, and greater financial incentives from CMS.

Addressing these factors is not a parallel effort, but an essential strategy for achieving better clinical and social outcomes. At Sociants, we reaffirm our commitment to being the bridge between quality and health equity, helping more health plans, providers, and organizations achieve their goals of excellence.

Quality begins with understanding each person's needs, and success comes when we all work together to meet them through measurable, data-driven care models that contribute to the quality of service provided to the individual.

Excellence isn't measured only in stars, but in improved lives. At Sociants, we're here to support you on this journey toward a more humane, higher-quality healthcare system. Toward a more humane, higher-quality healthcare system.