Description

In May 2015, the Mailman School of Public Health, through its Department of Health Policy and Management (HPM), and KPMG LLP (KPMG) jointly hosted a conference to consider key questions raised by New York’s Delivery System Reform Incentive Payment (DSRIP) and similar initiatives that seek to bridge the gap between social services and health. The conference included a panel that examined where social services fit in a re-defined health delivery system, another that asked whether and when health insurers should pay for such services, and a third that considered whether DSRIP represented a new approach or old wine in new bottles. To answer these questions, the conference brought together health policy leaders, academic researchers, healthcare consultants, and health and social services providers, all of whom provided a different perspective, a different expertise and a different set of expectations. Following the conference, Mailman faculty conducted site visits to two groups of DSRIP providers to make an even deeper dive into these efforts at population health management. This white paper seeks to integrate the expertise of conference participants with the lessons suggested from the academic literature and also the DSRIP site visits. We focus on four questions. First, why is the effort to integrate social and medical services so hard? Second, what are some examples of promising efforts at such integration? Third, does the evidence so far support the hopeful proposition that a higher priority for social services will improve health outcomes (and lower overall costs)? Fourth, and finally, what are the key takeaways for policymakers and academics alike?