Screening for Financial Hardship: Comparing Patient Survey Responses Using Two Different Screening Tools

Area of Science:

• Healthcare Delivery
• Social Determinants of Health
• Health Services Research

Background:

• Healthcare organizations increasingly screen for social risks.
• Screening tools vary in content and length.
• Standardized tools are needed for effective social risk assessment.

Purpose of the Study:

• To compare the Centers for Medicare & Medicaid Services (CMS) and National Academy of Medicine (NAM) social risk screening tools.
• To evaluate patient acceptability, positive screening rates for financial hardship, and interest in assistance.
• To inform the selection of appropriate social risk screening tools in clinical settings.

Main Methods:

• A cross-sectional survey design was employed.
• Adult patients (n=471) in primary care clinics were convenience sampled.
• Participants were randomized to complete either the CMS financial hardship tool or the NAM social and behavioral risk measures.

Main Results:

• Both tools demonstrated high patient acceptability.
• Positive screening rates for financial hardship were similar: 57% for CMS vs. 52% for NAM.
• Interest in assistance was significantly higher after using the CMS tool (39% vs. 21% for NAM).

Conclusions:

• Both social risk assessment tools are well-accepted by patients.
• The CMS tool may be more effective in prompting interest in assistance for financial hardship.
• Tool selection should consider the specific clinical setting, population, screening goals, and available resources.