Social Determinants Updates |
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March 31 to April 14, 2023
Welcome to Aligning for Health's bi-weekly Social Determinants Updates newsletter.
To add news or events to this newsletter, email info@aligningforhealth.org.
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Member News
Unite Us: Webinar Recap – A Look Back on How Unite Us and Local 211s are Collaborating (4/7) – Unite Us, United Way and 211 partners recently held a webinar on the organizations’ partnerships to build innovative care models. The goal was to shine a light on the three organizations’ partnerships and highlight the impact of these collaborations in communities across the U.S. This article provides a recap of the discussion.
Pittsburgh Business Times: UPMC’s Diane Holder discusses ways to improve efficiency, access in health care (4/6) – UPMC and UPMC Health Plan have increasingly focused on value-based care and social determinants of health to improve individual and community health by "connecting the dots" in health care and to close up gaps in care. The organization is focusing on making life better and more independent for people in more vulnerable groups, through medical and nonmedical programs, wrapping services like housing and food and training.
CareSource: CareSource partnership with Children’s Hunger Alliance helps expand Weekend Meals program (4/4) – CareSource announced the renewal of its partnership with Children’s Hunger Alliance (CHA) in support of CHA’s Weekend Meals program, which provides boxes containing a complete meal meeting USDA nutritional requirements. Recent funding from CareSource will allow CHA to expand the Weekend Meal program to additional early childcare and Head Start centers throughout Ohio.
American Hospital Association: Making Progress on Health Equity…But We Must Do More (3/31) – Last year, the American Hospital Association (AHA) asked hospitals and health systems to participate in AHA’s Health Equity Roadmap, a framework to support hospitals and health systems in their work to become more equitable and dismantle structural barriers to health and well-being. To-date, more than 1,000 hospitals and health systems have started their Health Equity Roadmap journey by taking AHA’s Health Equity Transformation Assessment.
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Legislative Roundup
Rep. Adams: Reps. Adams, Underwood & Sen. Booker Introduce Black Maternal Health Week Resolutions (4/13) – Reps. Adams (D-NC) and Underwood (D-IL) and Sen. Booker (D-NJ) introduced companion resolutions recognizing Black Maternal Health Week, “to bring national attention to the maternal health crisis in the United States and the urgent importance of reducing maternal mortality and morbidity among Black women and birthing persons.” Black Maternal Health Week is observed from April 11 – 17.
Strengthening Community Care Act
(4/10) - Reps. Joyce (R-PA), Blunt Rochester (D-DE), Stefanik (R-NY), and Fletcher (D-TX) introduced the Strengthening Community Care Act of 2023 (H.R. 2559), which would extend funding for community health centers and the National Health Service Corps. The bill would reauthorize funding for Community Health Centers through 2028 and provide continued access to care for over 30 million Americans in rural and underserved communities.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health in the 118th Congress, click here.
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Administration Updates
HHS: Administration for Children and Families Awards More than $375M to Reduce Poverty (4/12) – The Administration for Children and Families (ACF) announced the release of $375 million in Community Services Block Grant (CSBG) funding to help reduce poverty through community-based programming. This funding is the third installment of CSBG funding for states, territories, and tribes in FY23 to support services that alleviate the causes and conditions of poverty and brings the total CSBG funding released this fiscal year to more than $750 million.
HUD: HUD Awards $98M in Choice Neighborhoods Implementation Grants and Opens New $10M Funding Opportunity for Local Planning Efforts (4/11) – The U.S. Department of Housing and Urban Development (HUD) announced supplemental grant awards for Choice Neighborhoods Implementation Grantees. The program has a three-pronged “Housing, People, and Neighborhood” approach that includes redevelopment of distressed properties, support to housing residents related to the health, education, and income, and investments in neighborhood improvement projects which promote economic development and private investment.
HHS: HHS Proposes New Rule to Further Implement the 21st Century Cures Act (4/11) - The Office of the National Coordinator for Health IT (ONC) issued a proposed rule on health data, technology and interoperability, which would implement certain provisions of the 21st Century Cures Act and includes proposals on the movement of health information electronically and new data standards that help ensure information can be understood when it enters and leaves a system. Notably, ONC proposes to require certified EHRs to adopt USCDI version 3, which includes SDOH assessment, SDOH goals, SDOH interventions, and SDOH problems/health concerns. Information Page General Overview Fact Sheet At-a-Glance Fact Sheet ONC Blog Post
CMS: CMS Proposes Policies to Improve Patient Safety and Promote Health Equity (4/10) - CMS issued the calendar year 2024 Inpatient Prospective Payment System proposed rule, which makes payment and policy updates for inpatient hospitals participating in Medicare, in addition to quality program updates to the Promoting Interoperability program. Notably, CMS proposes to add 15 new health equity hospital categorizations for the FY 2024 IPPS payment impacts, and seeks comment on which specific SDOH Z codes were most likely to influence hospital resource utilization related to inpatient care, and proposed to focus on Z codes describing homelessness. Fact Sheet
CMS: CMS Finalizes Rule to Strengthen Medicare, Improve Access to Affordable Prescription Drug Coverage (4/5) - CMS issued the Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly Final Rule. Notably, CMS finalized its proposal to remove the reward factor and to add the addition of the Health Equity Index reward to the 2027 Star Ratings. This would summarize contract performance in relation to enrollees with certain social risk factors across multiple existing Star Ratings measures into a single score using data from the most recent two measurement years. Fact Sheet
CMS: Medicare Advantage Value-Based Insurance Design Model Extension
(4/5) - CMS announced additional details on the Medicare Advantage Value-Based Insurance Design (VBID) Model Extension. The model, which CMS recently extended from 2025 to 2030,will include several new policies intended to more fully address the health-related social needs of patients, advance health equity, and improve care coordination for patients with serious illness.
CMS: Approval of Arizona State Plan Amendment
(4/4) - CMS approved Arizona’s state plan amendment to provide 12 months of postpartum coverage to Medicaid-eligible pregnant individuals.
CMS: Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System Proposed Rule (4/4) - CMS issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for FY 2024. CMS stated in the proposed rule it was exploring ways to incorporate social determinants of health elements into the measure specifications and proposed a new health equity-focused measure. This measure would assess health equity and could include a structural, process, or outcome measure, such as a drivers of health measure in which residents are screened for specific health-related social needs.
CMS: HHS Updates 2024 Medicare Advantage Program and Part D Payment Policies
(3/31) - CMS released the Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the Rate Announcement). In addition to finalizing updates to MA payment growth rates and changes to the MA and Part D payment methodologies, CMS described a new HEDIS measure focused on screening and referral to services for social needs, Social Need Screening and Intervention (SNS-E), which would measure whether members were screened at least once during the measurement year. Fact Sheet
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SDoH & Health Equity in the News
Health Affairs: What Can We Learn from Medicaid About Making ACOs Equitable (4/13) – Medicaid accountable care organizations (ACOs) may have the most to teach us about how payers can structure their ACO initiatives to improve care for the most disadvantaged patients and thereby improve health equity. This article argues that while more research on equity-promoting ACO policies is needed, payers should learn from the Medicaid sector and focus on capacity-building for safety-net providers, engaging communities and the social sector organizations that serve them, and build toward meaningful equity incentives.
National Governors Association: Governors’ Top Health Priorities in 2023 State of the State Addresses (4/6) – This article highlights the issues that were top of mind for Governors in their respective State of the State addresses for 2023. Among the topics covered included health equity, maternal and child health, and social determinants of health. Notably, several Governors shared the need to create policies that improve a person’s well-being through SDOH. Common themes include improving access to care for rural populations, increasing food security, addressing homelessness and providing health care for Tribal communities.
Fierce Healthcare: Open access or referral only – Health systems take different approaches to food pantry programs (4/5) – Health systems and entities are taking various approaches to address food and nutrition security. Intermountain Primary Children’s Hospital in Utah, for example, announced the opening of a food pantry. At outpatient clinic visits, Intermountain patients are screeded for social determinants and then referred to the pantry to meet their needs.
STAT News: To build trust among LA’s unhoused, a street medicine team turns to technology (4/4) – Healthcare in Action, a division of SCAN Group, runs a street medicine team that visits unhoused patients across LA each day, providing services such as common medicines and supplies, physical and mental health exams, and connections to social services. The group also provides free device trackers, a completely optional resource unhoused patients can select so that the health care team can check up on them for routine visits or in case of emergencies – which has been successful given the trust Healthcare in Action has built within these communities.
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Maternal Health
AHIMA Foundation: AHIMA Foundation Announces Maternal Health Literacy for Nutrition Care Equity Initiative (4/13) – In honor of April’s Medicaid Awareness Month, AHIMA Foundation partnered with Mother of Fact and Claris Health to seek support for a national initiative to build health literacy and improve access to the evidence-based standard of care for pregnant people at risk of gestational diabetes. The Maternal Health Literacy for Nutrition Care Equity Initiative aims to build awareness and education around the critical importance of timely access to medical nutrition therapy for at-risk patients and the value of building health literacy as a risk reducer.
Patient Engagement HIT: Community Support Counters Racism Affecting Maternal Health Experience (4/12) – Recent research
published in the Annals of Family Medicine found that involving community support persons in the birthing experience can counter obstetric racism impacting the maternal health experience for Black mothers. This approach contributes to safer hospital environments and effectively addresses implicit bias.
Institute for Medicaid Innovation: IMI Identifies Community Priorities in Women, Gender, & Maternal Health (4/11) – A new Institute for Medicaid Innovation (IMI) survey
identifies the priorities of community members and individuals with lived experience with the Medicaid program in the field of women, gender, and maternal health. The top three priorities identified were maternal mental health, sexual and reproductive health, and doulas and perinatal community health workers, which differ from those identified among national health plans and policy leaders.
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Data & Innovation
Medical Economics: EHRs can help doctors integrate SDOH into patient care plans (4/11) – According to a recent study
in the Annals of Family Medicine, electronic health records (EHRs) can play an important role in determining patients’ SDOH needs and integrating those needs into care planning. The authors embedded card study surveys in the EHRs of 38 physicians and 21 primary care community health centers, consisting of questions about where the clinician obtained patients’ SDOH information and how it impacted clinical decision-making. Data from the surveys found that SDOH information influenced care in about 35 percent of visits.
Center for Health Care Strategies: Adopting a Community Resource Referral Platform – Considerations for Texas Medicaid Stakeholders (April 2023) – Regional projects in Texas that aim to develop Community Information Exchanges (CIE) or CIE-like structures are incorporating community resource and referral platforms to share data across multiple platforms. These projects are in their early stages but show promise to improve care coordination and data usability. This brief shares experiences from Medicaid stakeholders in Texas on using community resource and referral platforms to identify and address non-medical drivers of health, with lessons that can inform activities in other states to better address non-medical needs of Medicaid populations.
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New Research and Reports
SSRN: Blending and Braiding Funds – Opportunities to Strengthen State and Local Data and Evaluation Capacity in Human Services (4/13) - To better serve citizens and communities, state and local governments need a new approach to data and evaluation. By blending and braiding different programmatic funding streams and evaluating different operational structures, state and local leaders can make tremendous strides toward better data-based decision-making. Federal dollars as well as direct state or local appropriations can be combined to create cross-program data-sharing and integration strategies. This report examines leading programs across the U.S. doing this work to understand how they built their systems and successfully blended and braided funds.
JAMA Ophthalmology: Association Between SDOH and Examination-Based Vision Loss vs Self-reported Vision Measures (4/6) – This study examined how social determinants of health are associated with vision loss and whether these associations differ when using examination-based versus self-reported vision measures. Associations found between SDOH and vision impairment track together when using either clinically evaluated or self-reported vision loss, suggesting that using self-reported vision data can be used as a proxy measure to monitor SDOH and vision at the local level and over time.
Center for Health Care Strategies: Incorporating Community-Based Organizations in Medicaid Efforts to Address Health-Related Social Needs – Key State Considerations (April 2023) – State Medicaid organizations are increasingly looking to address health-related social needs, and encouraging more integration of community-based organizations (CBOs) with health care organizations (HCOs). This report explores insights from early state innovators to help guide states, HCOs, and CBOs in shaping and navigating successful CBO-HCO relationships, identifying best practices and implementation considerations for other states interested in strengthening CBO-HCO partnerships.
JAMA Health Forum: Association Between Community-Level Social Risk and Spending Among Medicare Beneficiaries (3/31) – This study examined the association between community-level social risk factors and spending among Medicare beneficiaries, and how it influences approaches to social risk adjustment. The study found that incorporating community-level social risk factors (using the Area Deprivation Index) into Medicare risk adjustment may not address payment disparities for many beneficiaries with high-levels of social risk.
Center for Health Care Strategies: Streamlining Data to Better Support Eligible Families – Medicaid and SNAP Data Coordination Case Studies (March 2023) – Improved data sharing between state Medicaid and SNAP agencies can benefit both eligible families and the agencies themselves by simplifying enrollment and administrative processes, while also facilitating eligibility determinations and targeted outreach to support more efficient enrollment for each program. The Improving Data Coordination Between SNAP and Medicaid initiative released three case studies highlighting efforts to improve data coordination between the programs.
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SDoH Opportunities
April - October
Rolling Basis
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