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The Role of Medicaid in Addressing Social Determinants of Health

Medicaid can play a major role in addressing the social determinants of health.

Or so argues a recent post on the Health Affairs Blog.

According to the post, social determinants of health – income, education, decent housing, access to food, and more – significantly influence the health and well-being of individuals – including low-income individuals who have adequate access to quality health care.  Medicaid, the post maintains, can play a major role in addressing social determinants of health.

The post outlines the role state Medicaid programs can play in addressing social determinants of health; describes tools for such action such as section 1115 Medicaid demonstration waivers; offers examples of efforts currently under way in some states; and presents suggestions for steps the federal government can take to facilitate such efforts.

Addressing social determinants of health is an especially important issue for private safety-net hospitals because they care for so many more Medicaid-covered low-income patients than the typical American hospital.

Learn more from the Health Affairs Blog post “For An Option To Address Social Determinants Of Health, Look To Medicaid.”

 

Medicaid to Help Pay for Food, Heat, Rent?

Maybe.

At least that is what Department of Health and Human Services Secretary Alex Azar hinted during a recent symposium held in Salt Lake City.

During the event, Azar said that HHS’s Center for Medicare and Medicaid Innovation seeks

…solutions for the whole person, including addressing housing, nutrition, and other social needs.

Azar hinted at future CMMI action, saying that

What if we gave organizations more flexibility so they could pay a beneficiary’s rent if they were in unstable housing, or make sure that a diabetic had access to, and could afford, nutritious food? If that sounds like an exciting idea … I want you to stay tuned to what CMMI is up to.

CMMI currently operates one major program that seeks to address social determinants of health:  the Accountable Health Communities model, which screens participants based on social determinants of health metrics, identifies those it considers to be at risk, and then works to link those individuals to local and community services that can help them address their health-related needs.

Significant numbers of the patients served by private safety-net hospitals face challenges posed by social determinants of health.

Learn more about Secretary Azar’s comments and the federal government’s outlook on using Medicaid to help address social determinants of health in this article in Becker’s Hospital Review.

States Pursuing Medicaid Reforms

A new Commonwealth Fund report looks at some of the changes states are pursuing in how they deliver and pay for care for their Medicaid recipients.

The review groups the reforms into three categories:

  • Managed care reforms – demanding more data to support bids for Medicaid managed care contracts and favoring bidders that include strong value components in their bids and that seek to address recipients’ social needs.
  • Focusing on beneficiaries with complex health and social needs – working with Medicaid managed care plans to address both the medical problems of members with complex medical conditions and the social determinants of health that cause, contribute to, or impede the treatment of those problems.
  • Integrating behavioral and physical health – expanding prevention and treatment of substance abuse disorders by restructuring delivery and payment systems.

Learn more about what states are doing to improve their Medicaid programs in the Commonwealth Fund report “Considering Federal Medicaid Policy Changes in Light of State-Level Delivery System Reforms,” which can be found here.

Medicaid Directors Meet

The National Association of Medicaid Directors held its fall conference recently outside Washington, D.C.

This is an important event at which policy-makers and policy experts meet to discuss Medicaid programs, trends, challenges, and opportunities.

Many of the materials used during that conference are now publicly available, including video clips from speeches by CMS Administrator Seema Verma and others and presentations on a number of subjects, including:

  • Medicaid’s role in supporting community engagement and economic mobility
  • busting the silos of physical and behavioral health care
  • alternative payment models and addressing the social determinants of health
  • early intervention in behavioral health
  • the opioid epidemic
  • pediatric innovations in Medicaid

Go here for links to the speeches and presentations offered at the conference.