American Hospital Association: (3/16) - The American Hospital Association released a new infographic highlighting five key ways to prioritize maternal mental health based on hospitals with successful programs. The infographic pulls from learnings shared on a podcast and webinar with hospitals that have strong and innovative maternal mental health programs.
3M: (3/14) - Population health and the payment arrangements it supports cannot be done successfully without incorporating social risk. This blog from 3M outlines the correlation between social risk and health outcomes in value-based payment arrangements, the unintended consequences of excluding SDOH in value-based care, and policies and regulations for a standard approach to social risk capture and accountability.
North Carolina Health News: (3/9) - On March 15, North Carolina rolled out its Healthy Opportunities Pilot, and the state’s Medicaid system will start reimbursing social welfare agencies to provide services to managed care recipients that address underlying food, housing, transportation, and violence issues that impact physical health. The project, which will be rolled out in three topical phases, draws funding from a Medicaid 1115 waiver that also authorized the state’s transition to managed care. Care managers working for Medicaid MCOs will determine if a beneficiary meets the eligibility criteria for the project, and if so, will move them onto the NCCARE360 platform which is powered by Unite Us. This will help streamline the connection between medical providers, managed care organizations, and the participating social services organizations.
Politico: (3/9) - When COVID hit, the urgency for the health care system to better coordinate health and social needs and connect people with resources became apparent. A growing number of states are turning to high-tech solutions and social service referral programs to address the social drivers of health. Unite Us is one such social referral platform, and now has presence in 43 states as of 2022. Alliance for Better Health, for example, introduced the Unite Us platform in six counties around Albany a few years ago to address social determinants, and has since grown to an 18-county network.
Blue Shield of California: (3/7) - Blue Shield of California, a health plan of the Blue Cross Blue Shield Association, announced it has made a $37 million contribution to the Blue Shield of California Foundation to support its efforts to end domestic violence and improve health equity. Debbie I. Chang, MPH, president and CEO of Blue Shield of California Foundation, noted: “The last two years have been especially challenging, particularly for communities of color with low incomes. We continue to strive to make a difference at the systems level to create lasting and sustainable change to achieve health equity and end domestic violence.”
Into the Light for Maternal Mental Health and SUD Act: (3/15) - Reps. Clark (D-MA), Herrera Beutler (R-WA), Matsui (D-CA), Burgess (R-TX), Clarke (D-NY), and Kim (R-CA) introduced the Into the Light for Maternal Mental Health and Substance Use Disorder Act of 2022 (H.R. 7073), which would reauthorize a grant program for screening, assessment, and treatment services for maternal mental health and substance use disorders. Sens. Gillibrand (D-NY), Capito (R-WV), Baldwin (D-WI), and Murkowski (R-AK) introduced companion legislation in the Senate (S. 3824).
Connect Unserved Americans Act: (3/11) - Reps. Johnson (R-SD), O’Halleran (D-AZ), Herrell (R-NM), and Kuster (D-NH) introduced the Connect Unserved Americans Act (H.R.7060), which would modify conditions of funding for the distance learning, telemedicine, and broadband program of the Rural Utilities Service.Summary
PREVENT Pandemics Act: (3/10) - Sens. Murray (D-WA) and Burr (R-NC) introduced the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act) (S.3799), which would aim to strengthen the nation’s public health and medical preparedness and response systems. Aligning for Health was pleased to see the inclusion of the section on social determinants of health in this legislation, as well as elements of the LINC to Address Social Needs Act (S. 509/H.R. 6072). This bill passed out of the Senate HELP Committee on March 15 after a markup was held on the bill, which included an amendment that would reserve amounts under the addressing social determinants of health and improving health outcomes for Indian Tribes and Tribal organizations. Section-by-section
Maternal and Child Health Stillbirth Prevention Act: (3/9) - Reps. Adams (D-NC) and Hinson (R-IA) introduced the Maternal and Child Health Stillbirth Prevention Act of 2022 (H.R. 7011), which would support stillbirth prevention and research. Sens. Merkley (D-OR) and Cassidy (R-LA) introduced companion legislation in the Senate (S.3797).
Black Maternal Health Caucus: (3/9) - Reps. Adams (D-NC) and Underwood (D-IL) released a statement following multiple provisions of the Black Maternal Health Caucus being passed as part of the Consolidated Appropriations Act, 2022. Key priorities that passed as part of this omnibus package include: $83 million for the Safe Motherhood/Infant Health Programs at the CDC; $30 million for the NIH Implementing a Maternal Health and Pregnancy Outcomes Vision for Everyone (IMPROVE) program; $748 million for the Maternal and Child Health Block Grant; $6 million for the Rural Maternity and Obstetric Management Strategies (RMOMS) program; and much more.
Housing for All Act: (3/8) - Reps. Lieu (D-CA), Carbajal (D-CA) and 11 cosponsors introduced the Housing for All Act of 2022 (H.R. 6989), which would address the homelessness and housing crises, to move toward the goal of providing for a home for all Americans. The bill would invest in proven solutions to address critical affordable housing shortages and provide a surge of funding for strategic, existing programs to reduce homelessness. Sen. Padilla (D-CA) introduced companion legislation in the Senate (S. 3788). Fact sheet
Military Family Nutrition Access Act: (3/8) - Sens. Duckworth (D-IL), Murkowski (R-AK), and 12 bipartisan cosponsors introduced the Military Family Nutrition Access Act (S. 3781), which would exclude a basic allowance for housing - a subset of military compensation intended to cover the costs of off-base housing - from income calculations for purposes of eligibility for the Supplemental Nutrition Assistance Program (SNAP). The bill aims to support active duty military families experiencing food insecurity and to prevent hunger in these families.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health, click here.
Aligning for Health Applauds Inclusion of Key SDOH Provisions in the Consolidated Appropriations Act, 2022
On March 15, 2022, President Biden signed into law the Consolidated Appropriations Act, 2022 (H.R. 2471). This bill consisted of all 12 fiscal year 2022 appropriations bills and supplemental funding to support Ukraine. The House passed this bill on March 9, 2022, and the Senate passed it on March 10, 2022.
Aligning for Health was pleased to see the inclusion of several key social determinants of health provisions included in this package. Along with the appropriations bill, the accompanying Joint Explanatory Statement and House Committee on Appropriations Report for the Departments of Labor, Health and Human Services, and Education, and Related Agencies for Fiscal Year 2022 Appropriations included specific instructions with respect to the appropriated amounts.
To view notable provisions related to social determinants of health, health equity, and maternal health that were included as part of this package, click here.
Support Legislation Endorsed by Aligning for Health!
QuadCities.com: (3/15) - This article highlights Congresswoman Cheri Bustos’ (D-IL) work in securing major provisions within the Consolidated Appropriations Act, 2022. This includes provisions that align with the Social Determinants Accelerator Act (H.R. 2503/S. 3039), which she co-sponsors with Reps Cole (R-OK), McGovern (D-MA) and Mullin (R-OK). The appropriations package included $8 million in funding to help local governments create plans to fight the social factors that harm long-term health through the CDC’s Social Determinants of Health Program.
Senator Chris Murphy: (3/15) - Senator Chris Murphy (D-CT) published a press release following the Senate HELP Committee passing the PREVENT Pandemics Act out of committee this week, highlighting four pieces of legislation included in the broader bipartisan pandemic response package. To improve the health and well-being of Americans and address the social determinants of health, the legislation included parts of both the Improving Social Determinants of Health Act and the bipartisan LINC to Address Social Needs Act (S. 509/H.R. 6072). This bill would offer grants to states to establish statewide or regional partnerships to better coordinate the work of health care and social services providers.
Inside Health Policy: (3/16) - Meena Seshamani, the Director for the Center for Medicare at CMS, spoke at AHIP’s annual conference on health policy this week and noted that plans should seek to address disparities in care and be good stewards of the funding they receive. Seshamani emphasized that health equity will remain a central pillar of CMS’ agenda for the year, and CMS will continue to collect more data on how inequities and social determinants of health impact specific groups of people nationwide, and what methods of addressing disparities have proven effective.
Politico Pro: (3/15) - The Biden Administration is in the early stages of putting together a White House Conference on Food, Nutrition, Hunger, and Health to take place later this year. The recent omnibus spending package for Fiscal Year 2022 included $2.5 million to fund this effort, which has the potential to spark major policy changes. While the timing of the conference is still to be determined, sources familiar with the planning anticipate it happening this fall. Reps. McGovern (D-MA) and Walorski (R-IN) and Sens. Booker (D-NJ) and Braun (R-IN) are also leading a bill (H.R. 5724/S. 3064) on this effort.
HHS ASPE: (3/14) - The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) announced its new Program Integrity and Effectiveness through Data and Analysis (PIEDA) initiative, which aims to enhance the capacity to share and link data between state child welfare and Medicaid agencies on issues at the nexus of the two systems. PIEDA intends to sustainably improve the data infrastructure of public agencies to increase their ability to analyze challenges experienced by families involved in child welfare systems, which may help public agencies improve their oversight of prevention services and health system interventions for children and families in, or at risk of being in, the foster care system.
CMS: (3/11) - CMS announced the launch of the Improving Maternal Health by Reducing Low-Risk Cesarean Delivery (LRCD) Learning Collaborative within the Medicaid and CHIP programs. Reducing the number of LRCD births is an opportunity for state Medicaid and CHIP programs to improve the quality of maternal and infant health and reduce overall maternal morbidity and mortality.
HHS ASPE: (3/7) - HHS ASPE released a report to identify social determinants of health that are risk factors for, or associated with COVID-19. The evidence provided by this scoping review findings calls for the standardization of SDOH data across health care, public health, and research.
CDC: (3/7) - The Centers for Disease Control and Prevention (CDC) announced it is seeking nominations for membership on the Advisory Committee to the Director (ACD) Health Equity Workgroup (HEW). The HEW will consist of approximately 15 members who are experts in fields associated with health equity; public health science and practice; and public health policy development, analysis, and implementation. Applications are due by March 17.
Federal Communications Commission:(3/3) – The Federal Communications Commission’s (FCC) Connect2Health Task Force hosted a virtual event which gathered public and private sector thought leaders from a variety of disciplines, including telecommunications and health care, to discuss issues around recognizing broadband connectivity as a social determinant of health. Achieving digital health equity through improving broadband access and adoption is an FCC priority and was an overarching theme of the event. Participants in the event explored the future of broadband-enabled health technologies and how FCC policies and programs could support ongoing innovations within the social determinants of health framework, among other things.
SDoH & Health Equity in the News
Fierce Healthcare: (3/14) - As health equity continues to take center stage in the health care industry, experts are laying out the business case for investors to back new innovations to address health equity. In a recent session at South by Southwest’s health and medtech conference, Myechia Minter-Jordan of CareQuest Institute for Oral Health said a number of persistent myths have hindered investment in health equity, such as the notion that Medicaid represents too narrow a market to focus on, while the opposite has proven true in multiple real-world examples.
Patient Engagement HIT: (3/14) - The role of the community health worker is becoming more prominent, which is leaving health care organizations to determine how to design community health worker training programs. With no mandated curriculum, organizations can design community health worker training programs with participatory learning principles to achieve core competencies.
Washington Post: (3/12) - Medicare Advantage plans nationwide have signed up with Papa to send Papa pals into the homes of seniors to provide companionship and help with everyday activities. Papa pals can also help beneficiaries fill out personal health risk assessments and undergo covered health screenings, which can help to identify members’ unmet social needs. This article provides more information on how Papa pals have addressed social isolation for seniors during the pandemic and more to address the overall health of beneficiaries.
Patient Engagement HIT: (3/11) - The National Committee for Quality Assurance (NCQA) launched the Health Equity Resource Center, a public website intending to enable better health equity practices among health care organizations. The Health Equity Resource Center will offer readers insight into the implications of health inequities and best practices to improve health disparities impacting patients.
Fierce Healthcare: (3/10) - As more health plans look to grocery deliveries to address food insecurity, experts say payers can use the deliveries to help fuel greater member engagement. Ashley Tyrner, founder and CEO of FarmBox, spoke about the need to use grocery deliveries to boost engagement with members and encourage them to use other social determinants of health benefits such as transportation during a recent session at the RISE 2022 National Conference.
McKinsey & Company: (3/10) - In this episode of the McKinsey on Healthcare podcast, McKinsey partner Carlos Pardo Martin talks with Errol Pierre, senior vice president of state programs at Healthfirst, about working with diverse communities, how to go all in on health equity, and the urgent need to ensure that vulnerable populations receive the care they need.
State of Reform: (3/10) - Peter Weir, MD, executive medical director of population health at University of Utah Health, leads the Intensive Outpatient Clinic, which focuses on addressing the social determinants of health by integrating physical and behavioral health. In this Q&A, Weir discusses the IOC, how the clinic addressed SDOH, and how other health systems can model their clinics after what they have learned.
Business Wire: (3/10) - Socially Determined announced a new social risk score that enables organizations to understand the impact social connections have on health outcomes and business performance. The Social Connectedness metric analyzes the influences of loneliness, social network quality, and social capital to deliver comprehensive insights into how they converge to impact a community and the people within it.
Patient Engagement HIT: (3/9) - Patients present with many different types of social determinants of health, meaning it may take numerous interventions to support patient wellness. But with these hospital- or clinic-based social service referrals being somewhat in their nascency, not every organization has a solution for every social determinant of health. This article highlights various strategies and interventions that organizations are designing focused on food security, housing security, transportation, and social needs screening.
Revcycle Intelligence: (3/8) - The American Medical Association is launching a network to advance health equity through an initiative that provides participating health care organizations with an investment framework that prioritizes the health of underserved and underrepresented communities. This initiative will help organizations center health equity and prioritize historically marginalized communities when choosing where to invest their resources and when designing, developing, testing and evaluating new programs.
Health Affairs: (3/8) - Health services, with its ties to the social sciences, has been somewhat more accepting of the notion that racism is a topic worthy of scholarly inquiry. However, direct discourse about racism has been limited. In this episode of A Health Podyssey, Ruth Enid Zambrana from the University of Maryland discusses the rich intellectual history of scholarship on racism and health.
Business Wire: (3/7) - Activate Care announced it is further expanding its presence in California, as it adds Central California Alliance for Health, Monterey County, and Health Plan of San Joaquin to the list of organizations who have chosen its CareHub platform to proactively manage their population’s social determinants of health. This announcement will help to drive long-term results centered around improving health outcomes and quality of life for Californians.
Fierce Healthcare:(3/4) - CVS Health invested $185 million in affordable housing last year, supporting the building and rehabilitating of more than 6,570 housing units in 64 cities across 28 states and DC. This also included 736 permanent supportive housing units that aim to provide stable homes for people and families who may be facing homelessness or other challenges. Residents of these units have access to a range of services intended to improve their health, such as behavioral health and social programs.
Spotlight on Maternal Health
NPR: (3/9) - A recent report from the CDC showed that pregnancy-related death rates are increasing - in 2020, pregnancy-related mortality rose by nearly 20 percent compared to the previous year and there was a growing disparity in mortality along racial lines. In this podcast, Rep. Alma Adams, Dr. Raegan McDonald-Mosley, and Nina Martin discuss how the pandemic impacted maternal mortality and what is being done to reverse long-standing inequities.
Inside Health Policy: (3/9) - The final omnibus spending package signed by President Biden this week will invest at least $30 million to address the country’s high maternal death rate, but notably excludes previous proposals to require states to provide 12-months of continuous Medicaid coverage for postpartum women. This article provides a roundup of the maternal health provisions included in the omnibus to address maternal mortality.
Healthcare Innovation: (3/7) - The American Heart Association announced it is committing $20 million in funding to the Health Equity Research Network (HERN) on Disparities in Maternal-Infant Health Outcomes research initiative. The initiative seeks to better understand the link between pregnancy complications and cardiovascular health among women and their babies.
Health Affairs: (March 2022) - This article highlights the move by Penn Medicine to tie executive compensation to the goal of reducing birth-related complications. For fiscal year 2021, health equity was added to the Penn Medicine team goals, which determine between 10-40 percent of compensation for more than 600 senior leaders. Whether Penn Medicine could reduce major maternal morbidity and maternal mortality among Black women would be factored into determining executive pay for the health system and medical school.
Data and Innovation
Healthcare IT News: (3/15) - Leaders from ATW Health Solutions spoke at HIMSS22 on how addressing health disparities requires gathering both quantitative and qualitative information. Panelists said that stratifying data by key demographics is a key way to spot potentially necessary interventions. However, understanding the “why” can help to match patients with interventions that will lead to improved outcomes.
Fierce Healthcare: (3/9) - Many experts at the RISE National Conference indicated health plans could face heavy barriers in getting and using actionable data from non-health care sources. Plans may have to figure out how to glean and digitize the information from non-health care stakeholders soon, as CMS asked for comments on potential equity quality measures to add in the Medicare Advantage and Part D Advance Notice. Some groups have been calling for CMS to create some standardization in how SDOH data are collected.
MedCity News: (3/7) - As the health care industry embraces breakthroughs in digital health, it is important to measure who is engaging and create and reward a digital health ecosystem that is responsible for tackling socioeconomic barriers by design. Doing so will help us get beyond the “check-the-box” answers and deliver equitable care through digital health.
New Research and Reports
Kaiser Family Foundation: (3/17) - COVID-19 has highlighted and exacerbated longstanding racial and ethnic disparities in health and health care. As a major source of coverage for people of color, Medicaid programs can help to address health disparities. This issue brief provides greater insight into the role Medicaid can play in advancing racial health equity by answering three key questions: 1) How does health coverage vary by race and ethnicity?; 2) How can Medicaid help to reduce racial health disparities?; and 3) What are the key issues to watch looking ahead?
Milbank Memorial Fund: (3/15) - The North Carolina Department of Health and Human Services launched its COVID-19 Support Services Program in August 2020 to address multiple pandemic-related social needs in counties with COVID-19 hot spots in four target regions of the state. Lessons from the COVID-19 Support Services Program can inform other states’ and payers’ efforts to address social needs, as well as North Carolina’s Healthy Opportunities Pilots, which will pay for and provide social services through Medicaid managed care programs. This brief offers key recommendations, stemming from interviews with the program’s administrators and frontline providers, to health policymakers creating or administering health policy programs to address social needs in local populations.
PLoS One: (3/10) - As Medicaid managed care organizations (MCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid beneficiaries, the purpose of this study was to describe MCOs experiences with addressing the social needs of Medicaid members during the pandemic. Four themes emerged: the impact of the pandemic, SDOH response efforts, an expanding definition of SDOH, and managed care beyond COVID-19.
Health Affairs: (3/10) - Stark disparities during the COVID-19 pandemic led to new health policy funding and interventions addressing social needs and social determinants of health to improve health equity. Lessons from these interventions and similar pre-pandemic initiatives can guide policy makers in designing more permanent approaches. This brief outlines strategies for health policy makers to address social needs and social determinants of health drawing on lessons learned from efforts and health policies implemented before COVID-19.
Becker’s Health IT: (3/10) - According to a report released by Edelman, how much trust a patient places in the health care system is a significant determinant of good health behavior. The report found that patients with lower trust levels are less likely to receive preventive care, and 72 percent of survey respondents with high levels of trust are likely to accept changing recommendations from health care officials versus 51 percent with low trust being likely to accept the same recommendations.
Patient Engagement HIT: (3/8) - According to the latest data in Health Affairs, medical-legal partnerships effectively mitigate some social determinants of health impacting pediatric populations, helping to reduce hospitalizations by over a third. Particularly, medical-legal partnerships can help children and their families ameliorate issues like potential eviction, denial of public benefits like food stamps or Medicaid/CHIP, and unhealthy housing situations. These social determinants of health can have downstream impacts, but the researchers showed that legal aid can help stem these factors and reduce high-acuity health care utilization.
Health Payer Intelligence: (3/4) - A report from North Carolina for Better Medicaid (NCBM) found that Medicaid managed care enables care coordination, incorporation of social determinants of health into care, trust-building between health care stakeholders, stakeholder accountability, and flexibility for Medicaid beneficiaries. North Carolina’s Medicaid managed care format relies on care management, and bringing multiple stakeholders together to address care management for beneficiaries helps integrate care that prioritizes whole-person health and addressing SDOH.
NYC Department of Health: (3/3) - During the Omicron surge, the COVID-19 hospitalization rate in New York City was more than two times greater among Black New Yorkers compared to White New Yorkers. Understanding why the dramatic inequities experienced by Black New Yorkers throughout the COVID-19 pandemic became worse during this most recent surge requires a deeper analysis and cannot be explained by simple factors. This white paper from the NYC Department of Health traces the cascade of factors that ultimately result in these inequities and lays out a roadmap for action.
Family & Community Health: (March 2022) - Health inequalities are characterized by spatial patterns of social, economic, and political factors. Life expectancy (LE) is a commonly used indicator of overall population health and health inequalities that allows for comparison across different spatial and temporal regions. This study examined geographic inequalities in LE across North Carolina census tracts by comparing the performance of two popular geospatial health indices: Social Determinants of Health (SDoH) and the Index of Concentration at Extremes (ICE). Results indicated that both metrics can be used to determine spatial patterns of inequities in LE and that the ICE metric has similar success to the more computationally complex SDoH metric.
Center for Health Care Strategies: (March 2022) - This report shares perspectives from Medi-Cal providers on how to effectively integrate adverse childhood experience (ACE) screening into clinical practice for children and adults in a trauma-informed manner. The insights gleaned from California-based providers can help inform health care organizations and providers working across the country to adopt ACE screening.