rwjf-tag: Addressing social determinants of health

Chen, M.A., Unruh, M.A., Pesko, M.F., Jung, H., Miranda, Y., Cea, M., Garcel, J.M., & Casalino, L.P. (2016, April). The role of hospitals in improving non-medical determinants of community population health. New York, NY: New York State Health Foundation.

This report examines how hospitals can define the population to which they are accountable, either as the patients attributed to them by payers, and/or as the people living in the surrounding communities. They can focus on medical care and/or create initiatives that impact the non-medical determinants of health for that population. Hospital executives are the… Read more »

Lantz, P.M, Rosenbaum, S., Leighton, K., & Iovan, S. (2016) Pay for success and population health: Early results from eleven projects reveal challenges and promises. Health Affairs, 35(11): 2053-2061.

In this article, authors conducted an analysis of the first eleven PFS projects in the United States to investigate the potential of PFS as a strategy for financing and disseminating interventions aimed at improving population health and health equity. The PFS approach has significant potential for bringing private-sector resources to interventions regarding social determinants of… Read more »

Adler, N.E., Cutler, D.M., Fielding, J.E., Galea, S., Glymour, M.M., Koh, H.K., & Satcher, D. (2016). Addressing social determinants of health and health disparities (Discussion paper: Vital directions for health and health care series). Washington, DC: National Academy of Medicine.

This paper discusses how addressing the social determinants of health can decrease health disparities. The authors utilize a health policy framework to address social determinants of health in order to better population health, reduce health disparities, and lower costs. The authors discuss key issues, cost implications, and barriers to progress, and examine health care financing… Read more »

Alley, D.E., Asomugha, C.N., Conway, P.H., & Sanghavi, D.M. (2016). Accountable health communities: Addressing social needs through Medicare and Medicaid. New England Journal of Medicine, 374(1), 8-11.

This perspective article examines the Accountable Health Community (AHC) model, in which the Centers for Medicare and Medicaid Services (CMS) invested a 5-year, $157 million test program. The foundation of this model is universal, comprehensive screening for health-related social needs in all Medicare and Medicaid beneficiaries who obtain health care at participating clinical sites. The… Read more »

Bachrach, D., Guyer, J., & Levin, A. (2016, July). Medicaid coverage of social interventions: A roadmap for states. New York, NY: Milbank Memorial Fund.

This issue brief is a practical guide for policymakers who want to know when and how states can use Medicaid to facilitate access to social services. It offers a road map of the legal authorities upon which policymakers can rely to extend Medicaid coverage to social interventions and provides examples of how Medicaid can be… Read more »

McGinnis, T., Bonney, J., & Chang, D. (2018). Innovative Medicaid payment strategies for upstream prevention and population health. Washington, DC: Academy Health, Robert Wood Johnson Foundation, & Nemours Children’s Health System.

This report describes a partnership between Nemours Children’s Health System and Maryland, Oregon, and Washington, to test how Medicaid payment authorities and new payment models could be used to support interventions to address the social determinants of health using a previously developed Medicaid Roadmap. This report illustrates the possibilities for using current Medicaid authority to… Read more »

Raday, S., Krodel, N., & Chan, A. (2018). Human services organizations: Partnering for better community health. New York, NY: Nonprofit Finance Fund. 

This report describes the Healthy Outcomes Initiative, which explored how community-based human services organizations can partner and integrate with health systems, insurers, and government to propel large-scale improvements in the health of America’s communities. Nonprofits and other community-based human services organizations are needed to provide the basic building blocks for health.

Murphy, T. & Majerol, M. (2017). Mindful Medicaid: Nudging expectant mothers and children toward preventative care. Deloitte Center for Government Insights.

This article discusses the importance of preventative or upstream interventions from the perspective of pre-term births and their prevalence in the United States. Authors identify techniques such as choice-architecture to adjust patient behaviors towards predefined optimums, commitment devices and reminders as programmatic tools to ensure predefined choices are adhered to and carried out, and social… Read more »

Magnan, S. (2017, October 9). Social determinants of health 101 for health care: five plus five. Washington, DC: National Academy of Medicine: HealthPartners Institute & University of Minnesota.

In this article, the author articulates five things we know and five things health care organizations need to learn to address social determinants of health for the national quality strategy. The authors acknowledge that critics are right to question how we address yet another issue in health care. However, organizations can define (and circumscribe) their… Read more »

Clemans-Cope, L., Wishner, J.B., Allen, E.H., Lallemand, N., Epstein, M., & Spillman, B.C. (2017). Experiences of three states implementing the Medicaid health home model to address opioid use disorder: Case studies in Maryland, Rhode Island, and Vermont. Journal of Substance Abuse Treatment, 83, 27-35.

This study examines state approaches to opioid health homes (OHH) and uses a retrospective analysis to identify facilitators and barriers to the program’s implementation from the perspectives of multiple stakeholders. Three states-Maryland, Rhode Island, and Vermont – adopted the ACA’s optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid… Read more »

Partnership for Healthy Outcomes. (2017). Housing is a health intervention: transitional respite care program in Spokane. Hamilton, NJ: Author.

This report is a case study of a transitional respite care program that uses recouperative care beds provided by homeless shelter for local hospital to which to discharge homeless post-op patients. The Transitional Respite Care Program (Respite Program) in Spokane, Washington, is a collaboration among Catholic Charities Spokane, Providence Sacred Heart Medical Center (part of… Read more »

Lee., J., & Korba, C. (2017). Social determinants of health: How are hospitals and health systems investing in and addressing social needs? Deloitte Center for Health Solutions.

The Deloitte Center for Health Solutions conducted a nationally representative online survey of about 300 hospitals and health systems to identify their current health-related social needs and activities and investments and their potential future efforts. To better understand how hospitals and health systems may be operating in the larger health care ecosystem and the challenges… Read more »

Paradise, J., & Ross, D.C. (2017, January). Linking Medicaid and supportive housing: Opportunities and on-the-ground examples. Menlo Park, CA: The Henry J. Kaiser Family Foundation.

This issue brief outlines ways in which Medicaid can support integrated strategies and, based on telephone interviews with key informants, profiles three current initiatives that illustrate distinctly different approaches to linking Medicaid and supportive housing. The three initiatives include one launched by a city (Philadelphia), one by a state (Louisiana), and one by a Medicaid… Read more »

The Scan Foundation. (2017, October). Top 10 recommendations to strengthen integrated care: Lessons from California’s dual eligible demonstration. Long Beach, CA: Author.

This brief describes recommendations to integrate health and human services. These recommendations include: integrating medicaid/medicare into a single health plan has benefits for beneficiaries; health plans need to use all available information and tools at their disposal; affordable housing is key to transitioning people from healthcare settings to the community; value based payment efforts will… Read more »

Butler, S.M., Matthew, D.B, & Cabello, M. (2017, February 15). Re-balancing medical and social spending to promote health: Increasing state flexibility to improve health through housing [Web log post].

This analysis is part of The Leonard D. Schaeffer Initiative for Innovation in Health Policy, which is a partnership between the Center for Health Policy at Brookings and the USC Schaeffer Center for Health Policy & Economics. The Initiative aims to inform the national health care debate with rigorous, evidence-based analysis leading to practical recommendations… Read more »

Gottlieb, L.M., Quinones-Rivera, A. Manchanda, R., Wing, H., & Ackerman, S. (2017). States’ influence on Medicaid investments to address patients’ social needs. American Journal of Preventive Medicine, 52(1), 31-37.

Despite widespread interest in addressing social determinants of health (SDOH) as a means to improve health and to reduce health care spending, little information is available about how to develop, sustain, and scale nonmedical interventions in diverse payer environments, including Medicaid Managed Care. This study aimed to explore how Medicaid Managed Care Organization (MMCO) leaders… Read more »

Gottlieb, L. Ackerman, S., Wing, H., & Manchanda, R. (2017). Understanding Medicaid managed care investments in members’ social determinants of health. Population Health Management, 20(4), 302-308.

This article examines Medicaid managed care investments in social determinants of health. Though interest in social determinants of health is widespread, but information about how to develop, sustain, and expand such efforts is scarce. While Managed Care Organizations are trying to make investments, several challenges exist including clinical integration, financing, sustainable funding, and regulatory constructs.

Walker, B.J., & Fishman, T.D. (2015). Rethinking human services delivery: Using data-driven insights for transformational outcomes. Deloitte.

This report argues that human service programs should be redesigned to serve customer segments, rather than administer services. Data-programs should be transformed through analytics in order to identify and address the problems that bring individuals and families into contact with the social safety net instead of through the lens of eligibility that only provides a… Read more »

Rosenbaum, S., Gunsalus, R., Velasquez, M., Jones, S., Rothenberg, S., & Beckerman, J.Z. (2018, March). Medicaid payment and delivery reform: Insights from managed care plan leaders in Medicaid expansion states. Washington, DC: The Commonwealth Fund.

In this brief, the authors aim to understand MCO experiences in Medicaid expansion states and learn about innovations related to access to care, care delivery, payment, and integration of health and social services to address nonmedical needs. Through interviews with leaders of 17 Managed Care Organizations (MCOs) in 10 states that have seen large Medicaid… Read more »

Van Beek, E., Eckel, D., Taylor, A. (2018). Investing in social services as a core strategy for healthcare organizations: Developing the business case. Washington, DC: KPMG Government Institute.

This report offers practical guidance that incorporates feedback from the field to providers and payers to help them get started on the integration of social determinants as part of their core business. Through case study analysis, the authors find that initial social service investments have the potential to yield high financial returns within a time… Read more »

Berkowitz, S.A., Terranova, J., Hill, C., Ajayi, T., Linsky, T., Tishler, L.W., & DeWalt, D.A. (2018). Meal delivery programs reduce the use of costly health care in dual eligible Medicare and Medicaid beneficiaries. Health Affairs, 37(4), 535-542.

In this article, the authors sought to determine whether home delivery of either medically tailored meals or nontailored food reduces the use of selected health care services and medical spending in a sample of adults dually eligible for Medicare and Medicaid. Compared with matched nonparticipants, participants had fewer emergency department visits in both the medically… Read more »

Wesson, D., Kitzman, D., Halloran, K.H., & Tecson, K. (2018). Innovative population health model associated with reduced emergency department use and inpatient hospitalizations. Health Affairs, 37(4), 543-550.

This article describes a strategy adopted by Baylor Scott & White Health to reduce rising rates of emergency department use and inpatient hospitalizations in an underserved Dallas community that is home to many people with low socioeconomic status. Baylor Scott & White partnered with the Dallas Park and Recreation Department to create a level-three primary… Read more »

Leider, J.P., Alfonso, N., Resnick, B., Brady, E., McCullough, J.M., & Bishai, D. (2018). Assessing the value of 40 years of public expenditures on health. Health Affairs, 37(4), 560-569.

In this article, the authors estimated the impact of local public hospital spending and nonhospital health spending on all-cause mortality in the county using county-level public finance data for the years 1972-2012. Overall, a 10% increase in nonhospital health spending was associated with a 0.006% decrease in all-cause mortality one year after the initial spending;… Read more »

Kinding, D.A., & Milstein, B. (2018). A balanced investment portfolio for equitable health and well-being is an imperative, and within reach. Health Affairs, 37(4), 579-584.

This commentary argues that the US health investment portfolio is out of balance, with too much spent on certain aspects of health care and not enough spent to ensure social, economic, and environmental conditions that are vital to maintaining health and well-being. Opportunities and challenges involved in rebalancing investments in ways that would improve overall… Read more »

Humana. (2018). 2018 bold goals progress report: Health happens where you are #morehealthydays.

This reports describes Humana’s Bold Goal, a comprehensive business and health strategy dedicated to improving the health of the communities Humana serves by 20% by 2020. Humana is prioritizing conditions and social determinants of health, both inside and outside of the clinical setting and tracking their progress using the CDC population health tool, Healthy Days…. Read more »

WellCare Health Plans. (2018). New study shows how managed care organizations can help address social determinants of health with new social-support role [Press release].

This press release announces new research released by WellCare Health Plans, Inc. and the University of South Florida and published in The American Journal of Accountable Care that examined how WellCare CommUnity Liaisons, a new social-support person role, effectively used their own personal experiences to provide social support to study participants (callers) experiencing a broad… Read more »

The Human Services Council of New York Commision on Value-Based Care. (2018). Integrating health and human services: A blueprint for partnership and action. New York, NY: Author.

The New York Human Services Council (HSC) convened the Commission on Valuebased Care to examine and inform the State’s health care reform efforts with a human services CBO lens. Over the course of a year, this group of leaders with experience and expertise spanning government, health care, philanthropy, academia, and human services explored areas including… Read more »

McGuire, J. (2016). Population health investment by health plans and larger provider organizations: Exploring the business case. Boston, MA: Northeastern University.

This report had two objectives: 1) To determine if there is a business case for the population health investments made by health plans and large provider organizations; and, if so, 2) To understand how business interests inform decision-making and affect the outcomes of population health investments. The author conducted an exploratory study composed of a… Read more »

Brooks, T., & Whitener, K. (2018). Leveraging Medicaid to address social determinants and improve child and population health. Washington, DC: Georgetown University.

This brief is intended to ground health care advocates on social determinants of health (SDOH) basics and describe ways Medicaid, in partnership with the health plans and providers that deliver public coverage benefits, can improve the health of enrollees by addressing the SDOH. It provides background and highlights resources that can support advocacy efforts to… Read more »

Easterling, D., & McDuffee, L. (2018, March 14). Finding leverage over the social determinants of health: Insights from a study of 33 health conversion foundations. Winston-Salem, NC: Wake Forest School of Medicine.

This article analyzed the strategic frameworks of 33 conversion foundations from throughout the US that have a reputation for addressing social and economic issues through interviews with foundation leaders. Authors identified five strategic pathways for improving social and economic condition that ranged from improving existing institutions to changing who has political power, and argue that… Read more »

Garrett, D., Hwang, A., & Pierce-Wrobel, C. (2018, May 30). Social determinants of health: A public health concept in conflict [Web log post].

This post discusses Centers for Medicare and Medicaid Services’ approval of states adding a work requirement as a condition of receiving Medicaid coverage, and the negative impact that is likely to have on citizens’ health outcomes. States are cautioned to be careful about implementing policies that may sound relevant to social determinants but will ultimately be… Read more »