Social Determinants Updates |
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March 17 to March 31, 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
BCBSA: Diverse, Inclusive Data Leads to Better Health Outcomes and Healthier Communities (3/28) – The Blue Cross Blue Shield Association (BCBSA) and the National Minority Quality Forum (NMQF) partnered to release recommendations for improving and standardizing data collection methods around race, ethnicity, and language (REL) and sexual orientation and gender identity (SOGI) to reduce health disparities and increase access to higher quality care for underserved populations. The issue brief addresses consensus-based policy options that will strengthen the data foundation and accrue to the benefit of all corporate and consumer stakeholders.
Healthcare Finance News: UPMC For You partners to offer Medicaid redetermination coverage in laundromats (3/27) – UPMC’s Medicaid managed care plan, UPMC For You, has announced a partnership with Fabric Health to provide on-site health support and social services access in certain laundromats. The initiative will provide WiFi access as Fabric Health staff in laundromats help individuals navigate access to preventative and other health care coverage, apply for assistance programs such as Medicaid and SNAP, and connect with other support services.
CareSource: CareSource and Central State University create new community health worker certificate program (3/24) – CareSource and Central State University recently announced a new pilot program providing training services to community members interested in becoming community health workers and patient navigators. The 12-week Community Health Worker Certificate Program will provide enrollees with skills such as interviewing, data collection, obtaining vital signs, mentoring, providing client advocacy, providing referrals to community resources, care coordination, and more.
Unite Us: Better Together – Uniting NYC to Address Nutrition and Beyond (3/21) - Health disparities among New Yorkers are significant, persistent, and increasing. Public Health Solutions (PHS) works to change that trajectory and supports New York City families to achieve optimal health and build pathways to reach their potential. PHS and Unite Us partner on WholeYouNYC, a city-wide community resource network that connects health care and social services.
Fierce Healthcare: North Carolina Blues plan says food-as-medicine program resulted in better outcomes for diabetes patients (3/20) – Blue Cross and Blue Shield of North Carolina, a health plan of BCBSA, launched a pilot program that takes aim at food insecurity in addressing the health care needs of beneficiaries. Blue Cross NC unveiled data published in NEJM Catalyst
about its proof-of-concept pilot program that involved delivering food to individuals in ACA plans who suffer from Type 2 diabetes as well as connecting them with health advisers.
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Legislative Roundup
Senior Hunger Prevention Act (3/29) – Sens. Casey (D-PA), Gillibrand (D-NY), Fetterman (D-PA), Blumenthal (D-CT), Kelly (D-AZ), and Warren (D-MA) introduced the Senior Hunger Prevention Act (S. 1036), which would increase the minimum monthly SNAP benefit for all participants and simplify the application and certification processes in nutrition programs so that beneficiaries don’t fall through the cracks due to administrative or logistical challenges.
MODERN WIC Act (3/27) - Sens. Gillibrand (D-NY) and Marshall (R-KS) introduced the More Options to Develop and Enhance Remote Nutrition in WIC Act (MODERN WIC) (S. 984), which would permit video or telephone certifications under the special supplemental nutrition program for women, infants, and children. On March 30, Reps. Fitzpatrick (R-PA) and Bonamici (D-OR) introduced the companion legislation in the House (H.R. 2424).
Military Food Security Act (3/27) – Reps. Panetta (D-CA), Moore (R-UT), Strickland (D-WA), Bacon (R-NE), Jacobs (D-CA), Levin (D-CA), and McMorris Rodgers (R-WA) introduced the Military Food Security Act of 2023 (H.R. 1764), which would expand eligibility for the Basic Needs Allowance (BNA) by excluding Basic Allowance for Housing (BAH) from income calculations that determine eligibility for the BNA. The removal of housing benefits from income computation to determine BNA eligibility would better target personnel facing the highest rates of hunger.
Military Family Nutrition Access Act (3/27) – Reps. Panetta (D-CA) and McMorris Rodgers (R-WA) introduced the Military Family Nutrition Access Act (H.R. 1763), which would provide essential support to military families in accessing healthy and affordable food options. The bill would exclude the Basic Allowance for Housing (BAH) from income calculations used to determine SNAP eligibility.
Mothers and Newborns Success Act (3/23) - Sens. Kaine (D-VA) and Murkowski (R-AK) introduced the Mothers and Newborns Success Act (S. 964), which would improve maternal health and promote safe motherhood. The bill would promote maternal health and reduce racial inequities in maternal and infant mortality by strengthening support for women during and after pregnancy, expanding maternal health research and data collection, and ensuring women are better matched with birthing facilities that meet their specific needs.
Housing is a Human Right Act (3/22) - Rep. Jayapal (D-WA) and 18 cosponsors introduced the Housing is a Human Right Act (H.R. 1708), which would address root causes of homelessness, meet the needs of community members experiencing harms from homelessness, transition communities towards providing housing for all, end penalization of homelessness, and ensure full democratic participation and inclusion of persons experiencing homelessness.
Healthy Moms and Babies Act (3/22) - Sens. Grassley (R-IA) and Hassan (D-NH) introduced the Healthy Moms and Babies Act (S. 948), which would improve maternal health coverage under Medicaid and CHIP. The bill builds on the Senators’ longstanding efforts to improve maternal and child health by delivering high-quality, coordinated care, supporting women and babies with 21st
century technology and taking steps to reduce maternal mortality.
Rural America Health Corps Act (3/22) - Reps. Kustoff (R-TN), Budzinski (D-IL), and Harshbarger (R-TN) introduced the Rural America Health Corps Act (H.R. 1711), which would establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program. Sens. Blackburn (R-TN), Durbin (D-IL), Capito (R-WV), Rosen (D-NV), Smith (D-MN), and Murkowski (R-AK) introduced the companion legislation in the Senate (S. 940).
Rural Health Innovation Act (3/22) - Reps. Kustoff (R-TN) and Kuster (D-NH) introduced the Rural Health Innovation Act (H.R. 1712), which would establish a rural health center innovation awards program and a rural health department enhancement program. Sens. Blackburn (R-TN) and Hickenlooper (D-CO) introduced the companion legislation on March 23 (S. 953).
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
FDA: National Minority Health Month – Better Health Through Better Understanding (3/31) - FDA released a blog on National Minority Health Month, highlighting the FDA Office of Minority Health and Health Equity's (OMHHE) 2023 theme to promote and protect the health of diverse populations through research and communication of science that addresses health disparities.
CMS: New Jersey FamilyCare Comprehensive Demonstration (3/30) – CMS approved New Jersey’s section 1115 demonstration waiver to provide housing and nutrition benefits to Medicaid recipients. The waiver includes two programs addressing nutrition – a medically indicated meals program for pregnant people who have or are at risk of diabetes, and nutritional support for people in its managed long-term services and supports program. The waiver also addresses housing needs for certain vulnerable groups.
CMS: CMS Announces Connecting Kids to Coverage HEALTHY Kids American Indian/Alaska Native 2023 Outreach and Enrollment Cooperative Agreement Grantees (3/30) – CMS announced the Connecting Kids to Coverage (CKC) HEALTHY KIDS American Indian/Alaska Native (AI/AN) 2023 Outreach and Enrollment Cooperative Agreements grantees. The Outreach and Enrollment Cooperative Agreement program provides funding to reduce the number of AI/AN children who are eligible for, but not enrolled in, Medicaid and CHIP, and to improve retention of eligible children who are enrolled in the programs.
HUD: HUD Announces $2.8 Billion in Annual Funding to Help People Experiencing Homelessness (3/28) – The U.S. Department of Housing and Urban Development (HUD) announced $2.8 billion in Continuum of Care (CoC) Competition Awards for thousands of local homeless service and housing programs across the United States. The awards will support the Biden Administration’s commitment to addressing the nation’s homelessness crisis using equity and evidence-based solutions.
FDA: Improving Health Through Nutrition Requires Continued Progress (3/27) - The FDA released a blog highlighting the FDA’s efforts to improve nutrition in recognition of National Nutrition Month. The FDA is embracing the National Strategy on Hunger, Nutrition and Health through the agency’s nutrition programs. For example, the FDA’s proposed redesign of the Human Foods Program includes the creation of a Center for Excellence in Nutrition.
The White House: Biden-Harris Administration Launches the White House Challenge to End Hunger and Build Healthy Communities (3/24) - The Biden Administration announced the White House Challenge to End Hunger and Build Healthy Communities, as a nationwide call-to-action for stakeholders to commit to advancing President Biden’s goal to end hunger and reduce diet-related diseases by 2030, while reducing disparities. The Biden Administration also announced two new actions under the National Strategy on Hunger, Nutrition and Health: draft guidance that offers food manufacturers recommendations on how and when they can use Dietary Guidance Statements on food labels to inform consumers about their products, and a proposed rule to reduce sodium in the food supply.
The White House: White House Office of Science and Technology Policy Announces Progress on Advancing Equitable Data (3/24) - The White House Office of Science and Technology Policy (OSTP) released a report on the progress the Biden Administration has made in collecting and analyzing data to help identify disparities in federal policies and programs in order to deliver more equitable outcomes for the American people. The report highlights the federal government’s progress in the following areas: making disaggregated data the norm, while protecting privacy; leveraging underused data; building capacity for robust equity assessment; and galvanizing diverse partnerships to provide accountability to the American people.
CMS: Biden-Harris Administration Announces the Expansion of Medicaid Postpartum Coverage in Oklahoma (3/23) - CMS announced that Oklahoma became the 30th state to be approved to extend Medicaid coverage for 12 months after pregnancy for women in the state. As a result, up to an additional 14,000 people in Oklahoma and an estimated 462,000 people across 30 states and D.C. will be eligible for Medicaid for a full year after pregnancy.
CMS: CMMI Extends Value-Based Insurance Design Model (3/23) – The CMS Innovation Center (CMMI) announced that the Medicare Advantage Value-Based Insurance Design (VBID) Model will be extended for calendar years 2025 through 2030 and will introduce changes to address health-related social needs, advance health equity, and improve care coordination.
USDA: Child Nutrition Programs: Community Eligibility Provisions – Increasing Options for Schools (3/23) – The U.S. Department of Agriculture (USDA) Food and Nutrition Service issued a proposed rule with request for comments to expand access to the Community Eligibility Provision by lowering the minimum participation threshold from 40 percent to 25 percent, which would give States and schools greater flexibility to choose to invest non-Federal funds to offer no-cost meals to all enrolled students. Comments are due May 8, 2023.
SAMHSA: Digital Access – A Super Determinants of Health (3/22) – The Substance Abuse and Mental Health Services Administration (SAMHSA) released a blog on how the digital divide intersects with equity and behavioral health. Internet access plays a role in health care outcomes and influences more traditionally recognized social determinants of health, such as education, employment, and healthcare access.
USDA: USDA Announces New Investments in School Meals to Support Healthy Kids (3/22) – USDA announced several actions to expand support for and access to school meal programs, including awarding $50 million in grants that will increase collaboration between schools, food producers and suppliers, and other partners to develop nutritious, appetizing school meals for kids. USDA also announced $10 million in grants for schools to expand nutrition education.
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SDoH & Health Equity in the News
Health Affairs: Accounting for Social Risks in Medicare and Medicaid Payments (3/27) – The authors of this article previously held a workshop about adjusting health care payments for social risk, which generated considerable stakeholder interest in developing program policy options specific to Medicaid and Medicare. Subsequent workshops resulted in a framework for policy opportunities based on four basic tenets, including increased funding for clinicians caring for disadvantaged populations to address social needs and making payment adjustments to sufficiently address social needs.
Fierce Healthcare: Instacart reaches deal with Boston Children’s to help deliver nutritious meals to patients (3/24) – Instacart announced several new tools for providers to get food to patients to address food insecurity. Instacart will offer a suite of digital tools to Boston Children’s Hospital to enable tailored nutrition deliveries to patients. One of the tools includes Fresh Funds, which are stipends that enable patients to directly purchase certain foods from Instacart.
Kaiser Health News: Fresh Produce is Increasingly Popular Prescription for Chronically Ill Patients (3/23) – The Montana Produce Prescription Collaborative (MTPRx) brings together several nonprofits and health care providers across Montana to support produce prescription programs throughout the state over the next three years. The goal is to reach more than 200 people across 14 counties in the first year of the initiative. Participating partners screen patients for chronic health conditions and food access, and eligible patients receive prescriptions in the form of vouchers or coupons for fresh fruits and vegetables.
Fierce Healthcare: Veterans Health Administration teams with About Fresh to scale up ‘food is medicine’ demonstration project (3/23) – About Fresh is partnering with the Veterans Health Administration (VHA) to create a large-scale demonstration project aimed at using healthy food to improve veterans’ health. About Fresh will use its digital Fresh Connect program to source better data, and data acquired with the VHA will help organizations learn how to design solutions for niche populations such as prescription programs for fresh produce.
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Maternal Health
Health Affairs: Community-based Doulas and Federally Qualified Health Centers – Addressing Climate Chang and Maternal Health (3/23) – Community-based doulas and federally qualified health centers (FQHCs) are committed to providing care and improving health outcomes for underserved pregnant people, who are often left out of climate change conversations. Given the similarities in their work and populations they serve, this article proposes that a collaborative between community-based doulas and FQHCs and the actions they can take can be a novel approach to mitigating the impacts of climate change on pregnant people in underserved communities.
Health Affairs: The Maternal Health Crisis Is A Consequence of Design
(3/20) - In 2023, the maternity care crisis is in large part a problem of design. Digitally enabled prenatal care is a promising solution for expanding prenatal services to close the preventability gap at every stage of pregnancy, regardless of a patient’s geography. Preventing maternal morbidity and mortality requires a paradigm shift in how we think about pregnancy care, moving from medical models to comprehensive care, from brick-and-mortar health systems to flexible services in people’s pockets.
Georgetown University Health Policy Institute Center for Children and Families: State Trends to Leverage Medicaid Extended Postpartum Coverage, Benefits and Payment Policies to Improve Maternal Health (3/20) - The new state Medicaid option to extend pregnancy coverage from 60 days to 12 months postpartum is an essential first step to giving new mothers ongoing access to care and helping them manage chronic conditions exacerbated by pregnancy, along with any other health care needs that arise during this family transition period. States should also take a closer look at the benefit and payment levers available in Medicaid to ensure that the longer coverage period translates to better access to needed care for mothers and infants in the postpartum year.
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Data & Innovation
Health IT Analytics: Socioeconomic Data Analysis Reveals Health Equity Barriers (3/17) – Researchers from Utica University recently leveraged socioeconomic data to gain insights into generational poverty and other health equity barriers that impact patients’ ability to prioritize their health in an effort to improve clinical outcomes. The research used data from health care revenue management software-as-a-service (SaaS) provider FinThrive, Inc. to examine the demographics and family structures of households within New York Communities, revealing a correlation between demographic characteristics and generational poverty.
AJMC: The PhenX Toolkit – Measurement Protocols for Assessment of SDOH (3/17) - The adoption of recommended, standard measurement protocols for social determinants of health will advance the science of minority health and health disparities research and provide standard SDOH protocols for inclusion in all studies with human participants. This study found that promoting adoption of well-established SDOH protocols can enable consistent data collection and facilitate comparing and combining studies, with the potential to increase their scientific impact.
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New Research and Reports
Health Affairs: Measuring and Addressing Nutrition Security to Achieve Health and Health Equity (3/30) - Given nutrition and health inequities in diet-related diseases, achieving nutrition security must be a priority for health care systems, government programs, and community efforts. This brief summarizes the increasing interest in nutrition security; the current state of screening and measurement tools, including intersections with measurement of food security and diet quality; what is known about trends and prevalence; and potential interventions to address nutrition security in different populations.
Patient Engagement HIT: How Food Swamps, Food Security Led to Chronic Disease, Obesity (3/20) – New data
from the Urban Institute corroborates the link between food swamps and chronic disease, particularly obesity. The study specifically showed that areas with a higher density of retail food chains overlap with regions with the highest obesity rates.
NEJM Catalyst: Two Questions Before Health Care Organizations Plunge into Addressing Social Risk Factors (3/15) - As experience with social risk interventions matures, and federal and state agencies consider ways to incentivize social risk interventions, this is an ideal time to ask whether we are going in the right direction with this work. In this perspective piece, the authors highlight that the focus on social risk screening and referrals rests on the assumptions: (1) that patients do not already know how to access resources; and (2) that resources to address patients’ needs are readily available. However, there is little evidence to support these assumptions.
Annals of Family Medicine: Patient-Reported Social Risks and Clinician Decision Making – Results of a Clinician Survey in Primary Care Community Health Centers (March 2023) – This study assessed the extent that patients’ social determinants of health influence safety-net primary care clinicians’ decisions at the point of care. The study also examined how that information comes to the clinician’s attention and analyzed clinician, patient, and encounter characteristics associated with the use of SDOH data in clinical decision making.
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SDoH Opportunities
April - October
Rolling Basis
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