Social Determinants Updates |
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January 21 to February 4, 2022
Welcome to Aligning for Health's bi-weekly Social Determinants Updates newsletter.
In this newsletter, you will find updates on how health care organizations are striving to meet health and social needs and invest in community health to improve health equity, as well as other notable links to research, data, and news related to social determinants, and upcoming virtual events and opportunities.
Follow us on twitter for more social determinants news: https://twitter.com/Aligning4Health
Do you have an event or opportunity coming up that you'd like to highlight? Email info@aligningforhealth.org to be included in the next newsletter.
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Member News
CareSource: (2/2) – CareSource joined forces with other thought leaders in Indiana to form a Health Equity Collaborative to dismantle the systems, biases and inequities that affect its members. The intent of this collaborative is to bring individuals together who represent a variety of populations to share their perspective and craft initiatives in which they can collaborate to affect positive health equity changes.
Health Leaders Media: (1/28) – In 2018, Alliance for Better Health formed the Healthy Alliance IPA as an affiliated limited liability company and it now has a network of more than 500 organizations serving 22 counties. Healthy Alliance IPA plays an intermediary role between managed care organizations and health care providers and their patients to connect patients with social determinants of health needs to social services.
Better Care Playbook: (1/25) – Recognizing the importance of family caregivers and the services they provide, some Medicare Advantage plans have capitalized on flexibility around supplemental benefits to better support family caregivers. In 2021, 95 plans offered caregiver supports as part of their benefit package, with that number jumping to 160 for 2022, representing a 68 percent increase. This blog post discusses the value of supporting family caregivers and highlights the activities of two MA plans ― UCare in Minnesota and UPMC Health Plan (UPMC) in Pennsylvania.
Healthcare Innovation: (1/21) – Last year Blue Cross Blue Shield of Massachusetts, a health plan of the Blue Cross Blue Shield Association, became the first health plan in Massachusetts to announce it would incorporate equity measures into its contracts and payment programs with clinicians. Mark Friedberg, M.D., senior vice president, performance measurement and improvement at Blue Cross, recently gave a presentation hosted by the National Committee on Quality Assurance in which he described how Blue Cross is beginning to work with provider organizations to implement pay for equity.
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Legislative Updates
Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act): (1/25) – Senate HELP Committee Chair, Sen. Murray (D-WA), and Ranking Member, Sen. Burr (R-NC), released a discussion draft of the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act), bipartisan legislation focused on strengthening the nation’s public health and medical preparedness and response systems in the wake of the COVID-19 pandemic. Sec. 201 of the discussion draft focused on addressing social determinants of health and improving health outcomes, including by authorizing grant programs to support evidence-based projects to reduce health disparities and improve health outcomes by increasing capacity to address social determinants within communities, among other provisions. Section by section Bill text
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health, click here.
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Administration Updates
CDC: (2/4) - CDC announces the 2022 Racial and Ethnic Approaches to Community Health (REACH) Lark Galloway-Gilliam for Advancing Health Equity Award Challenge (REACH Lark Award Challenge). This biennial challenge recognizes individuals, organizations, or community coalitions associated with the REACH program whose work has contributed to the implementation of culturally tailored interventions that advance health equity, reduce health disparities, and increase community engagement to address preventable risk factors ( e.g., tobacco use, poor nutrition, physical inactivity, and inadequate access to clinical services). Applications are due by March 18.
HHS: (2/3) - HHS announced the release of new reports on substance-exposed pregnancies, which highlighted how pregnant and postpartum women who use substances, and their children, can benefit from evidence-based prevention and treatment strategies. The reports identify strategies that can reduce negative health and well-being impacts of substance use on families, and were released in tandem with a $10 million SAMHSA grant program to provide residential treatment services for this population.
CMS: (2/2) - CMS released its proposed 2023 Medicare Advantage (MA) and Part D Advance Notice, and is specifically soliciting input through a health equity lens on its approach to future potential changes. CMS is seeking input on potential changes to the MA and Part D Star Ratings that would take into account how well each plan advances health equity, as well as comments on including a quality measure in MA and Part D Star Ratings that would specifically assess how often plans are screening for common health-related social needs. Fact sheet
HHS: (2/2) – HHS Secretary Becerra released a statement in honor of Black History Month, along with a fact sheet detailing the actions HHS has taken to advance health equity and improve health outcomes for Black communities.
National Quality Forum: (2/1) – The National Quality Forum (NQF) Measure Applications Partnership (MAP) submitted recommendations to HHS for performance measures used in federal health care programs. They reflect prevailing priorities such as advancing health equity and improving maternal health outcomes and behavioral health care. Notably, NQF conditionally endorsed two social drivers screening measures for inclusion in the Merit-based Incentive Payment System (MIPS) and Hospital Inpatient Quality Reporting (IQR) program.
CDC: (2/1) – CDC released a new webpage and suite of materials for health care professionals as part of the Hear Her campaign, which aims to reduce pregnancy-related deaths. The website contains specific information for obstetric providers, pediatric staff, and other health care professionals.
CMS: (1/27) – CMS committed $49.4 million to fund organizations that can connect more eligible children, parents, and pregnant individuals to health care coverage through Medicaid and the Children’s Health Insurance Program (CHIP). Awardees—including state/local governments, tribal organizations, federal health safety net organizations, non-profits, schools, and others—will receive up to $1.5 million each for a three-year period to reduce the number of uninsured children by advancing Medicaid/CHIP enrollment and retention. Applicants will be encouraged to consider a wide range of activities, including using parent mentors and community health workers to assist with enrollment, retaining coverage, and addressing social determinants of health.
HHS: (1/27) – On January 27, HHS Secretary Becerra hosted a virtual roundtable on nutrition and obesity, focused on tackling health disparities and addressing the disproportionate impact that the COVID-19 pandemic has had on people with obesity.
HHS Office of Disease Prevention and Health Promotion (ODPHP): (1/27) - Health and well-being are essential to individual and community resilience and thriving. Promoting enhanced individual and community resilience is foundational to equitable long-term recovery and resilience for the nation. It is also central to ODPHP’s mission of encouraging all Americans to lead healthy and active lives. This blog post by ODPHP Director RADM Paul Reed, MD, discusses this topic in further detail.
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SDoH & Health Equity in the News
Center for Health Care Solutions: (2/3) - States are increasingly focusing on health equity as a key priority within their Medicaid programs. Ensuring equitable access to high-quality and comprehensive primary care is central to achieving meaningful progress toward this goal, and one way states can advance more equitable primary care is to set standards for primary care practices that build on the patient-centered medical home framework. This blog post explores opportunities for states to use this framework and incentivize practice-level activities aligned with broader state health equity goals.
Commonwealth Fund: (2/2) – This post focuses on three policies that would promote a stronger and more equitable health insurance system: ensuring continuous postpartum coverage in Medicaid for low-income people, providing coverage to people in the Medicaid expansion gap, and extending the increase in marketplace premium subsidies established under the American Rescue Plan Act (ARPA). Enacting these coverage expansions has the potential to narrow gaps in health care access and improve economic disparities by making coverage and health care more affordable.
Patient Engagement HIT: (2/1) – A new $6.5 million investment from CVS Health will zero in on affordable housing in the Denver, Colorado area, with the overall goal to address a key social determinant of health. The funding, awarded in partnership with Boston Financial Investment Management, will go toward building a 36-unit affordable housing complex set to serve individuals currently experiencing homelessness and individuals with physical, intellectual and/or developmental disabilities.
Digital Journal: (2/1) – Intermountain Healthcare is making significant contributions to the Wasatch Front Regional Council (WFRC) and Utah League of Cities and Towns (ULCT), to help enhance community health by focusing on the social determinants of health throughout Utah. Intermountain is contributing a total of $1 million – $500,000 each to WFRC and ULCT.
Health Payer Intelligence: (1/31) – As Oregon establishes a public option in order to address health equity, it could merge this work with its efforts to unify health equity goals across health insurance markets and the state. The state has determined that: “Oregon will have established a health system that creates health equity when all people can reach their full health potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances.”
Patient Engagement HIT: (1/28) – A new partnership between the Mass General Brigham and The New Commonwealth Racial Equity and Social Justice Fund (NCF) will invest $2.5 million to improve maternal health equity, support a diverse maternity practitioner workforce, and boost patient care and clinical outcomes. Health equity experts with the partnership will focus on strategies to improve clinical outcomes, improve health literacy for Black and Brown patients, and increase the number of clinicians of color in Massachusetts.
Health Affairs: (1/27) – Health Affairs Editor in Chief Alan Weil details in this blog post Health Affairs’ approach to addressing equity as an organization. He highlights the need to be publicly accountable in their actions. Health Affairs decided to start with racial and ethnic disparities in their efforts, as racial and ethnic minorities are significantly less likely to publish in scholarly publications.
Patient Engagement HIT: (1/26) – Ever since value-based care models pushed the social determinants of health to the forefront, and the dual tragedies of the COVID-19 pandemic and the murder of George Floyd gave rise to health equity discussions, the landscape of the medical field has changed. Health care professionals are now zeroing in on where health disparities exist—inequities affect different people across nearly every disease state—and are forging ahead with solutions to close the outcomes gap across race, age, gender, income level, sexual identity, and any number of sociodemographic factors.
Health Leaders Media: (1/25) – Health care organizations are using digital health and virtual care to expand their options for care management and coordination, especially with behavioral health. New strategies involve identifying and addressing social determinants of health, which sit outside the clinical realm but affect health and wellness. The challenge lies in finding the right tools to improve patient engagement and ensure that patients are developing better habits.
Medscape: (1/25) – American Indians are twice as likely as White persons to have diabetes, and food insecurity also affects approximately one in four American Indians. To address these disparities, experts recommend increasing access to health insurance, especially Medicaid; when states increase access or pull back access to Medicaid, it disproportionately impacts American Indians in terms of their access to care, particularly children.
Milbank Quarterly: (1/24) – Author John E. McDonough argues that evictions should be considered as part of the social determinants of health. He calls for further research which might show CMS whether this could be a cost-effective way to reduce Medicaid medical costs and align with CMS’s new social determinants agenda.
World Economic Forum: (1/20) – The pandemic response highlighted how a chronic lack of safe and affordable housing is one of the biggest drivers of health and wealth disparities around the world. Governments, corporations and civil society have important roles to play in advancing disruptive solutions to the chronic shortage of safe, affordable housing around the globe.
Patient Engagement HIT: (1/20) – For even the most seasoned of hospital systems, health equity work always brings something new. Between the changing needs of the community and the evolving capabilities of the hospital, progress in closing health disparities and supporting health equity requires regular assessment. Such was the case at UI Health, where health equity has been baked into everything UI Health does for decades, but that doesn’t mean the organization can skate by without iteration.
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Data and Innovation
EHR Intelligence: (1/26) - CareAdvisors, a health IT firm in Chicago, tapped the CommonWell Health Alliance network to create an open-source data sharing service to support health equity efforts. Care Advisors’ equity information exchange (EIX) combines patient medical information with human services data related to social determinants of health, and provides access to over 150 million patient records through CommonWell Health Alliance’s nationwide network.
AJMC: (1/25) - On this episode of the Managed Care Cast, the hosts speak with Michael Sun, a medical student at the Pritzker School of Medicine at the University of Chicago, who served as first author of a Health Affairs study showing that race and bias were significantly associated with negative patient descriptors in the electronic health record.
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The Kaiser Family Foundation updated a chart pack analyzing a wide array of measures of racial and ethnic disparities in health and health care and other factors which can contribute to these disparities. One section of the chart pack focused on SDOH, finding that overall, Black, Hispanic, AIAN, and NHOPI people fared worse compared to White people across most examined measures of SDOH for which data were available.
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New Research and Reports
Center for American Progress: (2/3) - North Carolina has developed a large-scale, comprehensive approach to addressing unmet nonmedical needs through Medicaid using a Section 1115 Waiver. Through this waiver, the state developed the Healthy Opportunities Pilots program to put Medicaid dollars toward evidence-based interventions to target social determinants of health. This report considers the health landscape in North Carolina, where many residents have social needs that put them at high risk of inequities, and considers the merits of the Healthy Opportunities Pilots program. Fact sheet
National Health Council: (2/2) - The National Health Council released a new report, entitled “Access, Affordability and Quality: A Patient-Focused Blueprint for Real Health Equity.” This report marks the culmination of a year of multi-stakeholder discussions of multiple health equity issues, which resulted in a number of policy recommendations.
Pharmacy Times: (2/1) - A new study published in Obesity found that cumulative social disadvantage, as denoted by higher social determinants of health burden, is associated with higher likelihood of obesity independent of clinical demographic factors. Investigators said that limited empirical data suggest correlations between obesity and individual SDOH. However, the SDOH-obesity link has not been examined from an upstream cumulative social disadvantage standpoint.
Mayo Clinic Proceedings: (2/1) - This study examined the association of social determinants on prevalence of stroke in non-elderly adults. Nearly half of all non-elderly individuals with stroke had an unfavorable SDOH profile, suggesting that standardized assessment of SDOH risk burden may inform targeted strategies to mitigate disparities in stroke burden and outcomes in this population.
Business Wire: (2/1) - A new national survey by Teva Pharmaceuticals and Morehouse School of Medicine found that access barriers due to COVID-19 impacted groups that are already likely to be more vulnerable, with caregivers (58 percent), women (53 percent), patients (74 percent), BIPOC (45 percent), and those with anxiety (29 percent) and depression (25 percent) reporting greater difficulty with health care access.
Patient Engagement HIT: (1/31) - A study in the Journal of Urology found that health care professionals and patients alike agree that social determinants of health screening is feasible and beneficial in the clinical setting, but added supports are necessary to ensure these assessments don't add to clinician burden. Clinics may consider having a licensed social worker or community health worker to facilitate social services referrals and patient navigation, as well as dedicated staff members for entering SDOH data into the EHR.
Better Medicare Alliance: (1/26) – New research conducted by NORC at the University of Chicago and Better Medicare Alliance highlights best practices in addressing social determinants of health for Medicare Advantage beneficiaries. NORC’s research compiles 13 case studies based on interviews with 12 leading Medicare Advantage plans, provider groups, and community partners; offering valuable insights to policymakers as they seek to integrate lessons learned from the COVID-19 response and assess how to best address the needs of an increasingly diverse Medicare population.
Patient Engagement HIT: (1/26) - A study in JAMA Internal Medicine found that staff members’ implicit bias about minority groups was linked to variability in end-of-life care delivered to Black patients with dementia, limiting health equity for nursing home residents. Study findings showed that staff in all nursing homes expressed implicit biases.
PR Newswire: (1/25) – In its first report as a certified Medicare Qualified Entity (QE), Blue Health Intelligence examines the relationships among preventable diabetes, hypertension admission rates and socioeconomic status (SES) measures to deliver preventive care to reduce avoidable hospitalization. The report's findings reinforce the profound impact that social determinants of health, including SES, have on health outcomes.
Milbank Memorial Fund: (1/24) - This report reviewed the research literature to assess the evidence supporting whether policy initiatives targeting primary care access in five specific dimensions have been effective in reducing health care disparities. The policy initiatives considered in the report vary widely in terms of the decision makers best suited to implement them and therefore will require multi-sector collaborative solutions to improve access to primary care in underserved areas.
Yale School of Management Insights: (1/24) – At age 65, all Americans become eligible for Medicare. In a new study, Yale SOM’s Paul Goldsmith-Pinkham and his co-authors use this sudden transition to test whether universal health coverage can help reduce racial disparities in health.
The Commonwealth Fund: (1/20) - Despite enduring racism and the need for greater racial equity, there is limited consensus among analysts, academics, and public officials on how to assess policy for its impact on racial equity. Without instructive conceptual frameworks, our ability to identify, examine, and eradicate racial inequity through health policy will be limited. This issue brief aimed to establish a conceptually nuanced, empirically informed, and practically useful framework for analyzing the racial equity implications of health policies.
NEJM Catalyst: (January 2022) - A Flexible Services Program launched by Massachusetts Medicaid in January 2020 and funded under a Section 1115 waiver allows accountable care organizations (ACOs) to address health-related social needs of enrollees with complex care needs or risk factors for housing instability or food insecurity. The ACOs are encouraged to partner with social service organizations to provide needed supports. This study shares ACO leader perspectives on the various types of payment strategies used with social service organizations, challenges experienced, and the impacts of these partnerships.
Health Affairs: (January 2022) - Racial and ethnic disparities in adults’ access to dental care have persisted for decades. This study examined how recent Affordable Care Act Medicaid expansions that included coverage of dental services for adults affected racial and ethnic disparities in dental services use. The study found that expansions including extensive dental benefits were associated with narrowed racial and ethnic disparities in dental care visits and use of preventive and treatment services.
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Upcoming Events
February
February 4 - NIH National Institute on Minority Health and Health Disparities, “National Advisory Council on Minority Health and Health Disparities Meeting.” Virtual.
February 7 - Bipartisan Policy Center, “Child Nutrition Report Release.” Virtual.
February 8 - Health Affairs, “Racism & Health Virtual Symposium.” Virtual.
February 10 - Social Current, “Building Healthier Communities: The Power of Technology to Facilitate Community Investment.” Virtual.
February 10 - Center for Health Care Strategies, “Using Health System and Provider Culture Change to Address the Impact of Racism and Bias on Patient Outcomes.” Virtual.
February 10 - BioCrossroads, “Social Determinants of Health: How can we make collective impact in Indiana?” Virtual.
February 16 - Systems for Action, “Multisector Task-Sharing to Improve Mental Health in Harlem, NY.” Virtual.
February 16-17 - WEDI, “Leveraging Data and Technology to Support Health Equity.” Virtual.
February 17 - Bipartisan Policy Center, “Getting Serious About Housing Supply Series: Aligning Housing Subsidies.” Virtual.
February 17 - The Children’s Inn at NIH, “How Pediatric Clinical Research Can Promote Health Equity.” Virtual.
February 22 - Center for Health Care Strategies, “Setting Standards for Advanced Primary Care through Medicaid Managed Care: Considerations for Promoting Equitable Pediatric Care.” Virtual.
February 23 - Health Payer Intelligence, “Building Population Health Data Infrastructure to Address Social Needs.” Virtual.
March
March 2 - Systems for Action, “Social Bonds as a Pooled Financing Mechanism to Address Social Drivers of Health Equity.” Virtual.
March 10 - AHIP, “A Pragmatic Approach to Addressing Health Equity.” Virtual.
March 16 - HIMSS, “Digital Connectivity as a Social Determinant of Health.” Virtual.
March 16 - Systems for Action, “Integrating Health and Social Services through a Novel Independent Practice Association.” Virtual.
March 20-22 - RISE, “The Rise Summit on Social Determinants of Health.” Nashville, TN.
March 25 - American Academy of Pediatrics, Illinois Chapter, “Addressing Health Equity and Impact of Racism on Child and Adolescent Health: What Can Be Done?” Virtual.
March 29-30 - USAging, “Aging Policy Briefing & Capitol Hill Day.” Washington, DC.
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SDoH Opportunities
Request for Collaboration
The Food as Medicine Collaborative in San Francisco is looking to evaluate the impact of their Food Pharmacy program on the clinic staff who coordinate it. Does your organization provide medically-supportive food and nutrition interventions (i.e. produce prescriptions, medically tailored meals, food pharmacies, etc.) and have you received feedback from clinic staff? If so, please reach out to efraney2@jhmi.edu
February - April
Rolling Basis
- Deadline: Open - Aligning for Health, Endorse the Social Determinants Accelerator Act
- Deadline: Open - Aligning for Health, Endorse the LINC to Address Social Needs Act
- Deadline: Open - Chairman McGovern, Endorse the White House Conference on Food, Nutrition, Hunger, and Health Act
- Deadline: Open - Trust For America’s Health, Endorse the Protecting the Health of America’s Older Adults Act
- Deadline: Open - Anthem Foundation, Request for Proposals: Food as Medicine RFP
- Deadline: Open - House Committee on Rules, Request for Stories: Experiences, Research, and Solutions to Guide Committee Work in Addressing Hunger
- Deadline: Open- Robert Wood Johnson Foundation, Open Call for Proposals - Evidence for Action: Innovative Research to Advance Racial Equity
- Deadline: Open - Sepsis Alliance, Pledge for Equity, Diversity, and Inclusion In the Fight Against Antimicrobial Resistance, Sepsis and its Underlying Causes
- Deadline: Open - Arnold Ventures Advancing Medicare & Medicaid Integration initiative, Funding Opportunity: Technical Assistance to Advance Medicare and Medicaid Integration for Dual-Eligible Individuals.
- Deadline: Open - Opportunity Starts at Home, Send a Letter: Tell Congress to Enact the Bipartisan “Family Stability and Opportunity Vouchers Act.”
- Deadline: Open – Robert Wood Johnson Foundation, Evidence for Action: Investigator-Initiated Research to Build a Culture of Health.
- Deadline: Open - TFAH, Endorsement of the Improving Social Determinants of Health Act.
- Deadline: Open - American Hospital Association, Hospital Community Collaborative National Cohort Application.
- Deadline: Open - The de Beaumont Foundation and Johns Hopkins University, Stories of Alignment: Share a reflection related to the “Seven Ways Business Can Align with Public Health for Bold Action and Innovation” report
- Deadline: Open - Data Across Sectors for Health, Survey: 2021 National Inventory of Data Sharing Collaborations for Health
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