Differences in health care costs between two social health support programs: findings from a randomized social health integration pilot program.

introductionMore health systems are implementing strategies to understand and address patient social health, also known as social health integration. We examine the impact of a pilot social health integration program in two primary care clinics in an integrated health care system on health care costs.

methodsWe randomized 534 patients who reported any social need between October 2022 - January 2023 to receive support from a centralized Connections Call Center (CCC) or clinic-based Community Resource Specialists (CRS). We used administrative and claims data to compare costs between programs incurred by the health care system over 9 months. Using an intent-to-treat approach, we used two-part models to estimate costs for behavioral health, emergency department, inpatient admissions, and urgent care. We estimated single-part models using generalized linear models for primary care, specialty care, and total costs. Our secondary as-treated analyses compared costs among those who received support from CRS to those who did not.

resultsUnadjusted results showed no significant differences between CRS and CCC participants. Adjusted findings showed that CRS participants had $286 higher primary care costs than CCC participants (95% CI: $63.61, $508.89). As-treated findings showed that those who received CRS assistance had $2,356 more specialty care costs (95% CI: $229, $4,482) than those who did not.

conclusionsObserved changes in primary and specialty care costs may be a result of increasing engagement with the health system that could support patients in managing their health and prevent avoidable utilization in the long-term. These findings can help inform others who are interested in adopting similar primary care interventions.