# Midwestern health system study: four social needs outside CMS screening mandate exceed all required ones

- Published: 2026-11-13 09:44 UTC
- Section: Life & Health › Medicine
- Tags: health-related social needs, CMS screening mandate, hospital social needs screening, Journal of General Internal Medicine, Midwestern health system, food insecurity, housing insecurity, social connections, health literacy, patient demographics
- URL: https://realtech.media/news/rt-9702b3e8d8e59ae92d69dbdf_midwestern_health_system/

**In screening data from 559,118 adults, barriers due to physical or mental health were reported by 23.6%, more than any domain CMS requires hospitals to screen.**

![Midwestern health system study: four social needs outside CMS screening mandate exceed all required ones](https://realtech.media/media/2026/11/c589d78be55d7c60.jpg)
*U.S. Navy photo by Petty Officer 2nd Class Jacob Woitzel, Wikimedia Commons, Public domain*

Researchers analyzed social needs screenings of 559,118 adult patients in a large Midwestern health system in the USA, completed from July 2021 to June 2023. The cross-sectional study, published in the Journal of General Internal Medicine, compared five domains that the Centers for Medicare and Medicaid (CMS) mandated hospitals to screen for in 2024-2026 with eight additional domains. Four of the non-mandated categories were more prevalent than any mandated one [1].

## Which needs were reported most often

The five CMS-mandated domains were domestic violence, food insecurity, housing insecurity, transportation insecurity and utility affordability. The additional eight covered barriers due to physical or mental health, dependent care, employment, education, healthcare affordability, literacy, legal issues and social connections [1]. Barriers due to physical or mental health were reported by 23.6% of patients screened for them, education by 11.4%, social connections by 10.4% and literacy by 5.3% [1].

According to the publication's summary, the most frequent mandated domain was utility affordability at 5.1%, and domestic violence was the least frequent need overall at 0.9%. Patients completed 1,515,560 screenings in total. Procedures varied: some clinics screened for single needs such as food insecurity, while others sent a questionnaire covering all thirteen domains a week before the visit.

## Differences across patient groups

The authors used generalized estimating equation models to account for repeated screenings of the same patient. Black patients and patients of Other race, patients aged 18-29 and 50-64, and patients with Medicare/Medicare Supplement, Dual Medicaid + Medicare, Self-pay and Other insurance had higher odds of reporting all five CMS-required needs [1]. For Black patients, adjusted odds ratios were 4.29 for food insecurity, 6.23 for housing, 1.59 for domestic violence, 2.42 for transportation and 5.30 for utility affordability. Relative odds for the other domains varied with demographic characteristics [1].

The sample was 59.8% female, 63.6% White and 88.8% non-Hispanic. The health system serves an underserved population, with over 30% of patients on Medicaid or unable to pay. The authors state that future research should investigate what drives differences in reported prevalence, and that determining which domains should be mandated by bodies such as CMS is important for addressing needs that affect health [1].

## Sources

1. [Journal of General Internal Medicine](https://doi.org/10.1007/s11606-026-10991-6)
2. [bioengineer.org](https://bioengineer.org/hospital-study-finds-unmandated-social-needs-often-exceed-mandated-screening-rates)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-9702b3e8d8e59ae92d69dbdf_midwestern_health_system/