Our Client Results / Quality & MIPS Consulting

Medical Center Improves Quality and Clinical Outcomes Through Enhanced Health Screening for Social Determinants 


After two months of working with Medical Advantage, this medical center achieved the following: 


Built a formal screening process to identify if patient has any (SDOH)



 Social screenings and tracked (PCMH) capabilities


Quality and decreased healthcare cost


Patient, physician, and care manager relationships

Overview of Medical Center 

For over 77 years, this medical center has cared for the Fenton, MI, community, serving all patient demographics, but primarily Medicaid and Medicare patients. It is a multi-provider independent primary care practice that offers family practice medicine, pediatrics, internal medicine, gynecology, geriatric medicine, dermatology, preventative medicine, and chiropractic services.  

In 2009, the center was designated as a Patient-Centered Medical Home and has been re-appointed each year due to the quality of care and performance standards achieved by reaching patient care goals.


The SDOH screenings were required as part of the medical center’s participation in a large payer’s population health management initiative. The medical center was challenged with how to integrate SDOH screenings to meet the payer’s requirements.  The staff struggled to implement a program and properly act on positive screen results primarily due to: 

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Staff concern over SDOH screening being intrusive to the patient.

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Staff knowledge gap about community resources to assist patients with positive SDOH screens

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Perception of the additional screen as an administrative burden to practice staff

Our Solutions

Using its Practice Catalyst methodology, Medical Advantage in-practice consultants assessed practice processes and workflows, identified process gaps, developed an action plan, and implemented educational interventions. The educational interventions were conducted with both practice staff and leadership to gain support in implementing:  

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Gradual integration of the SDOH screening in practice workflow starting with small subsets of the patient population

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Face-to-face meetings with practice staff and leadership to answer questions and troubleshoot issues

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A customized integration plan of action based on staff size, workflow, and current staff responsibilities and expectations

Medical Advantage Can Help

Medical Advantage is an innovator in healthcare. Our years of experience, data driven strategies and in person approach drive change, improve outcomes, and maximize ROI. Our team has the expertise to provide customized, actionable solutions to decrease the cost of care and improve quality for your practice.

Medical Advantage - TDC Group