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.
BioSpace: (12/2) - Blue Cross Blue Shield of Massachusetts, a health plan of the Blue Cross Blue Shield Association (BCBSA), announced it will contribute $25 million to support local health care organizations in their efforts to eliminate racial and ethnic inequities in care. Also within the last month, the health plan announced it would build an incentive program rooted in race data, physician practice leadership, and value-based purchasing (VBP), focusing on existing HEDIS data to reveal multiple racial and ethnic disparities and link solutions to its VBP model.
Michigan Health Information Network Shared Services: (12/1) - The Michigan Health Information Network Shared Services (MiHIN) announced it will collaborate with Velatura Public Benefit Corporation and findhelp to establish a national health information exchange (HIE) portal, advance shared application programming interfaces (APIs) and provide a pathway to interoperable referrals. This partnership will provide a safe, secure and effective platform to connect patients with social services.
Healthcare Innovation: (11/30) - The Healthy Alliance IPA, an affiliate of the Alliance for Better Health, is planning to expand its work across New York and recently announced a partnership with Unite Us to convene regional community leaders and thousands of local community-based organizations across the state. The Healthy Alliance IPA has been cited as a successful example of an emergency SDOH network taking a holistic approach to addressing the full spectrum of a region’s social care needs.
Health Leaders Media: (11/24) - The Idaho Health Data Exchange (IHDE) modernized its patient matching technology and reduced data duplication by less than one percent. IHDE recently became the first health information exchange (HIE) in the nation to sign a statewide license with findhelp.org, which will aid in its expansion of the type of data it collects. The new FHIR-based data warehouse will be able to ingest more data as health insurers are required in 2022 to share data among themselves in FHIR format.
American Hospital Association: (11/24) - In the latest American Hospital Association Advancing Health podcast, Virtua Health discussed how it has empowered OB-GYN physicians and nurses to integrate protocols that lowered C-section, hypertension and hemorrhage rates for patients in labor.
Employee Benefit News: (11/23) - Although 60 percent of veterans are eligible for care through the Department of Veterans Affairs, fewer than half use VA benefits. Taylor Justice, co-founder of Unite Us, has first-hand experience with seeking out and connecting with the right resources and providers as a veteran. He launched Unite Us to address this issue and address the gaps in health and social service care not only for military personnel and their families, but all individuals in need of services to address their social needs.
Vizient: (11/22) - Vizient is working to support its members in advancing health equity and improving community health by providing insights, analytics, education and other actionable solutions. However, closing the gaps in health outcomes also requires the support of policymakers. Vizient outlined how policymakers could assist in this in its recent comments in response to the Congressional SDOH Caucus request for information.
Times Union: (11/21) - The Healthy Alliance IPA, an affiliate of Alliance for Better Health, partnered with the United Way of the Greater Capital Region to launch the Changemakers Fund, a grant program allotting 13 BIPOC organizations money to support their missions on the front lines of the pandemic. The missions of the organizations varied from addressing food insecurity to health care disparities.
Post-Gazette: (11/19) - A new report by the Commonwealth Fund found deep health inequities in every state, including Pennsylvania where the mortality rate for Black infants was more than twice the rate for white infants. UPMC has enhanced maternal screening for depression in recent years, which has been associated with infant hospitalization and mortality during the first year of life. UPMC has also doubled the number of doulas who accompany and counsel women during and after childbirth.
3M: (November 2021) - Extensive research has demonstrated that an individual’s socioeconomic status (SES) impacts the health care services they receive, health outcomes, patient satisfaction and physician perception of the care and treatment needed. This study by 3M Clinical and Economic Research evaluated the impact of SES on the performance of health care delivery systems using nine performance measures in four categories: population, post-acute care, quality, and service volume.
Social Determinants of Health Data Analysis Act: (11/30) - The Social Determinants of Health Data Analysis Act of 2021 (H.R. 4026) passed the House in a vote of 399 – 28. The bill requires the Government Accountability Office to report on actions taken by the Department of Health and Human Services to address social determinants of health, including how data collection about social determinants of health complies with relevant privacy laws. The bill now goes to the Senate for consideration.
LINC to Address Social Needs Act: (11/23) - Reps. Kildee (D-MI), Walorski (R-IN), Blunt Rochester (D-DE), and Hudson (R-NC) introduced the Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (H.R. 6072), which would establish a program to assist States in establishing or enhancing community integration network infrastructure for health and social services.
Build Back Better Act: (11/18) - The House passed the Build Back Better Act (H.R.5376). The bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, housing, child care, and health care. The Build Back Better Act makes significant investments to improve racial and ethnic maternal health disparities, and advance birth equity across the United States, including provisions from the Black Maternal Health Momnibus Act and permanent yearlong postpartum Medicaid coverage. The bill now moves to the Senate for consideration. Key provisions
Healthy MOM Act: (11/18) - Sen. Brown (D-OH) and 14 cosponsors introduced the Healthy Maternal and Obstetric Medicine (Healthy MOM) Act (S.3239), which would provide for a special enrollment period for pregnant persons.
WIC Healthy Beginnings Act: (11/17) - Sens. Gillibrand (D-NY) and Marshall (R-KS) introduced the WIC Healthy Beginnings Act (S. 3226), which would permit video or telephone certifications under the special supplemental nutrition program for women, infants, and children.
House Passes, President Biden Signs Bills for Veterans: (11/15) - The House passed by voice vote five bipartisan bills, including S. 1031, which would require the Comptroller General of the United States to conduct a study on disparities associated with race and ethnicity with respect to certain benefits administered by the Secretary of Veterans Affairs. The House also passed the Protecting Moms Who Served Act of 2021 (S. 796), which would codify maternity care coordination programs at the Department of Veterans Affairs. President Biden signed both bills into law on November 30.
Supporting Healthy Mothers and Infants Act: (11/9) - Reps. Manning (D-NC), Thompson (R-PA), Trone (D-MD), Guthrie (R-KY) and Kuster (D-NH) introduced the Supporting Healthy Mothers and Infants Act of 2021 (H.R.5934), which would support women, infants, and children impacted by substance use disorders.
To view a full list of the legislation we are tracking around social determinants of health, health equity/disparities, and maternal health, click here.
Bipartisan Representatives Introduce the LINC to Address Social Needs Act in the House!
On November 23, Representatives Kildee (D-MI), Walorski (R-IN), Blunt Rochester (D-DE) and Hudson (R-NC) introduced the Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (H.R. 6072). Similar bipartisan, bicameral legislation was previously introduced by Senators Sullivan (R-AK) and Murphy (D-CT) in February 2021 (S. 509).
The LINC to Address Social Needs Act will help to build or enhance statewide or regional collaborations to better coordinate health care and social services by leveraging local expertise and technology to help connect people to food, housing, child development, job training, and transportation supports and services.
The White House: (11/22) - In response to the recommendations of the Presidential COVID-19 Health Equity Task Force, Vice President Harris announced a $1.5 billion investment in the National Health Service Corps, Nurse Corps, and Substance Use Disorder Treatment and Recovery programs to expand and diversify the health workforce and improve critical clinical care in underserved communities. These programs address workforce shortages and health disparities by providing scholarship and loan repayment funding for health care students and professionals, in exchange for a service commitment in hard-hit and high-risk communities.
HHS: (11/18) - CMS approved Virginia’s 1115 waiver demonstration to extend Medicaid and CHIP coverage up to 12 months postpartum. CMS is also approving Virginia’s request to provide coverage to those postpartum individuals who are beyond the 60-day state plan postpartum period but who are still within the 12 months post-pregnancy period. This means that individuals who are eligible for extended postpartum coverage may be enrolled in Medicaid or CHIP for the purpose of receiving the extended postpartum coverage benefit at any time during the 12-month period following the end of pregnancy.
AHRQ: (11/18) - HHS Agency for Healthcare Research and Quality (AHRQ) issued a new report highlighting the impact of AHRQ-funded research over the past year in the areas of patient engagement, supporting clinicians and improving the delivery of health services. The report also includes eight impact stories including improving medication safety with accurate e-prescribing and the use of social needs screening to help with monitoring patients post-discharge.
CMS: (11/17) - The CMS Office of Minority Health made multiple data and visual enhancements to the Mapping Medicare Disparities (MMD) tool. Enhancements include the addition of preliminary 2020 Medicare FFS data, COVID-19 hospitalization and prevalence rates, and an updated map legend to improve visualization.
CMS: (11/16) - CMS Administrator Brooks-LaSure and Center for Medicaid & CHIP Services (CMCS) Director Tsai published a blog in Health Affairs outlining their strategic vision for Medicaid and CHIP. The vision describes CMCS’ policy agenda and focuses on three key areas: 1) coverage and access; 2) equity; and 3) innovation and whole-person care.
OMB: (11/12) - The White House Office of Management and Budget (OMB) recently published a public summary of responses to its RFI seeking input, information, and recommendations on available methods, approaches, and tools that could assist in identifying effective methods for assessing whether agency policies and actions equitably serve all eligible individuals and communities. OMB received over 499 responses to the RFI. Nearly half of all comments discussed data collection, disaggregation and reporting, and over one-third of comments touched on various dimensions of health care and health equity.
The White House: (11/10) - In response to the recommendations made within the White House COVID-19 Health Equity Task Force final report, the Biden-Harris Administration announced it would invest an additional $785 million in American Rescue Plan funding to develop equity-focused programs and initiatives in communities that have been disproportionately impacted by the COVID-19 pandemic. This would include $35 million to the CDC to expand recruitment and pipeline programs to increase diversity, equity and inclusion in the public health workforce, and $240 million to HRSA to develop the pipeline of public health workers in the most underserved communities through apprenticeship programs that provide education and job training in emergency departments, health centers and clinics.
SDoH & Health Equity in the News
Manatt: (11/29) - States have helped mitigate poor health outcomes of millions of Americans throughout the pandemic by facilitating easier access to SNAP benefits. This article highlights new evidence on the relationship between SNAP enrollment and reduced Medicaid costs and details how state Medicaid agencies can leverage contracts with Medicaid managed care organizations (MCOs) to advance SNAP enrollment.
Health Affairs: (11/29) - Investing in more meaningful data collection and disaggregation is critical to advance health and racial equity, yet this work is expensive and is not regularly funded. This article calls on the philanthropic community to play a role in the call for disaggregated data to achieve health equity, emphasizing the urgency around demanding, funding, and using disaggregated data that allows us to fully see people, populations, assets, and gaps.
Rheumatology Advisor: (11/24) - In this episode of the Rheum Advisor On Air podcast, rheumatologist Iris Y. Navarro-Millán, MD provides a deeper insight into understanding social determinants of health as drivers of health disparities in rheumatology and urges researchers and clinicians to look beyond just race and ethnicity when addressing these disparities.
McKinsey & Company: (11/24) - Health care payers have a significant opportunity to improve nutrition and have a positive impact on health given the role they play as a primary source of benefits for many individuals. As such, many payers have adopted nutrition benefits and programs, however there is an opportunity for payers to realize greater benefits through targeting and personalization, reinforcing partnerships and referral pathways, and taking a holistic approach to quantifying impact on health and business outcomes.
Patient Engagement HIT: (11/22) - Boston Medical Center launched an initiative called the Health Equity Accelerator, which will focus on addressing racial health disparities by utilizing researchers, clinicians, and patient insight to close existing gaps in health care. The tools that are part of this initiative will focus on the discrepancy in health outcomes among patients of different races and ethnic backgrounds, and will involve engagement with community partners and patients.
American College of Radiology: (11/22) - Eight major radiology organizations have formed the Radiology Health Equity Coalition to improve health equity in the radiology space. The coalition will collect, assess, and disseminate resources and best practices, advocate for and connect with patients and community members, and collaborate on programs and services to improve access to and utilization of preventive and diagnostic imaging.
CVS Health: (11/22) - CVS Health announced it will invest $7.7 million with Raymond James Tax Credits Funds in Tampa to build a 61-unit multifamily apartment home development. The investment is part of the company’s commitment to addressing racial inequity and social determinants in underserved communities.
Health Affairs: (11/19) - Existing disparities in access to care and other predictors of health status led to both increased risk of COVID-19 disease burden and increased risk of negative economic and social effects among Latinx communities during the pandemic. The LATIN-19 coalition has helped bridge the gap among these communities by linking community engagement and empowerment to policy change and by addressing immediate social needs community members faced during COVID. This article describes key strategies for creating policies that embed health equity principles in their design and implementation to move us closer to an equitable health care system.
Managed Healthcare Executive: (11/19) - Transportation barriers have often been cited as a barrier to health care access, and can lead to missed appointments, delayed or missed care, and other negative outcomes. Addressing transportation access by ensuring dependable and safe transportation to health care services can help improve patient satisfaction and outcomes and lower health care costs. This article explores how using predictive analytics to address transportation as a social determinant of health can achieve this goal.
NCQA: (11/17) - The National Committee for Quality Assurance (NCQA) announced it will use its experience evaluating health care quality and performance to accelerate improvement in inequitable care. NCQA’s new Health Equity Accreditation program sets a robust framework for organizations to identify and close individual care gaps to collectively improve health equity nationwide.
Health Affairs: (11/17) - In this piece, authors and executive leaders across payer, provider and life sciences sectors convened to develop recommendations to maximize the impact of funding from the American Rescue Plan to extend their reach to strengthen services that address drivers of health. The authors note that the scope and time frame to use these funds create an opportunity for public- and private-sector leadership to engage in partnerships focusing on investment in drivers of health, and put forward several recommendations for effective use of these funds and such engagement.
Modern Healthcare: (11/17) - The Physician Foundation has been active on recognizing and acting on challenges related to social drivers of health. Recently, the Foundation submitted the first-ever SDOH measure set for consideration by CMS, focused on screening patients for food insecurity, housing instability, transportation, utility needs and interpersonal safety. This article discusses this initiative in more detail, calling for SDOH comorbidities to be recognized and acted upon.
Patient Engagement HIT: (11/17) - Medical schools are beginning to build up a health equity curricula and revamp plans for diversity, equity and inclusion as they look ahead to training the next generation of medical professionals. Groups like the American Association of Colleges of Osteopathic Medicine (AACOM) and their member colleges are pushing their existing health equity efforts further to ensure students are trained to deliver medicine to a diverse patient population.
No Kid Hungry: (11/16) - No Kid Hungry was awarded funding through the Gus Schumacher Nutrition Incentive Program (GusNIP) through the USDA National Institute of Food and Agriculture. This grant will allow the organization to launch Healthy Families Rx, which would integrate food and nutrition into preventative health care visits for Aetna Medicaid members. The program will also incorporate SNAP referrals, nutrition counseling, and Produce Rx vouchers into well-child visit protocols for Medicaid.
New Research and Reports
Center for Health Care Strategies: (12/2) - Consistent access to affordable, nutritious food is a challenge for many Medicaid enrollees, and the overlap in eligibility between Medicaid and SNAP provides an opportunity for better coordination. State agencies, including Medicaid and social service agencies, increasingly recognize the importance of integrating individual and community voices in policymaking, especially those from communities of color who experience disparities in food security. This report offers recommendations for policymakers to integrate individuals with lived expertise as partners in program and policy design, implementation, and evaluation to address food insecurity more effectively.
American Academy of Pediatrics: (12/1) - Community health worker (CHW) programs represent a promising way to screen for social determinants of health and connect patients to resources, but the impact of such programs in the inpatient pediatric setting has not been widely examined. This study evaluated a CHW program for children hospitalized with asthma in a predominantly Hispanic community by examining rates of SDOH and social resource navigation.
Rutgers University-New Brunswick: (11/30) - A study published in the Journal of Racial and Ethnic Health Disparities examined whether health disparities in populations most impacted by COVID-19 were the result of higher exposure rates to the virus or due to social determinants of health. The study results suggest that disparities in COVID-19 outcomes stem from potential upstream issues such as underlying conditions, access to testing, and access to care rather than disparities in exposure to the virus.
Oncology Nurse Advisor: (11/24) - According to a study in Clinical Journal of Oncology Nursing, nurses tended not to consider social determinants of health when speaking with cancer patients or making recommendations about physical activity, despite the role they play in patient outcomes. When SDOH-related factors were considered in dialog and decisions, the most common taken into consideration were social and community context.
Fierce Healthcare: (11/23) - The Institute for Medicaid Innovation released its annual Medicaid MCO survey report, which found that seven in 10 health plans said they offered a plan that aimed to address health inequities. About 90 percent of health plans worked with community health centers and 95 percent worked with community-based organizations to address the social needs of members, and 70 percent of plans indicated they have a health equity plan, among other results.
Patient Engagement HIT: (11/22) - According to a report from March of Dimes, racial maternal health disparities have persisted despite success in reducing the overall pre-term birth rate for the first time in six years. Black and American Indian/Alaska Native people have seen an increase in pre-term births, and are 60 percent more likely to experience pre-term birth than white people.
Business Wire: (11/17) - A study from Anthem Inc. found that eight in 10 people in Indiana believe inadequate housing, access to mental health care and financial insecurity are the three factors that most negatively impact the health of individuals living in the state. The survey found that many are not familiar with the concept of SDOH, but 80 percent of respondents believed the pandemic has caused them to be more aware of their physical and mental health.
Managed Healthcare Executive: (11/16) - A study published in JAMA Network Open examined the associations of race and ethnicity with COVID-19 positivity rates, mortality, hospitalization and ICU admissions in the US. These outcomes were associated with various SDOH through adjusted and unadjusted relative risk ratio and odds ratio calculations. The study found that members of racial and ethnic minority groups had a higher risk of COVID-19 infection and disease severity.
Patient Engagement HIT: (11/16) - A study by researchers at Boston Medical Center found that unstable housing and homelessness are associated with a heightened risk of COVID-19 re-infection. Researchers compared several clinical and demographic characteristics, finding that the only demographic factor linked to re-infection was homelessness or unstable housing.
The Commonwealth Fund: (11/16) - The COVID-19 pandemic has brought increased attention to the need to address the maternal health crisis in the US through a multifaceted approach that addresses ingrained racial and geographic disparities. This report seeks to inform policy aimed at lowering rates of maternal morbidity and mortality and eliminating inequities, highlighting the evidence underpinning various approaches and the importance of employing an equity framework in designing and implementing these policies.
Brookings Institution: (11/15) - This study examined what state governments can and should do to encourage healthy housing markets. The study identifies four goals to guide statewide housing policies: 1) analyze state housing market conditions to design appropriate policies; 2) encourage housing production in places with strong demand; 3) provide financial support to low-income households; 4) reduce climate risks.
Build Healthy Places Network: (11/15) - A new paper published in Academic Pediatrics introduces the community development sector to health care practitioners and provides recommendations and successful examples of community development efforts targeting child health and wellbeing. The paper introduces a broad network of organizations, policies, and financial resources that are working to improve zip codes by tackling poverty at the neighborhood level.
Stewards of Change Institute: (11/15) - A new report from the Stewards of Change Institute (SOCI) examines informed consent across health, social services, and SDOH and highlights the importance of consent and trust to improve health-related data sharing, outcomes and equity.
Data and Innovation
American Journal of Preventive Medicine: (12/2) - This study seeks to evaluate the differences in the prevalence of conditions as well as utilization and cost between patients with and without health-related social needs, and finds increased prevalence of numerous high-priority conditions as well as increased utilization and costs among patients with documented health-related social needs.
Avalere: (11/30) - The FY2022 update of CMS Z codes included 19 new codes related to SDOH to help providers collect data on the non-clinical conditions impacting health outcomes for patients. This article explores how Z codes present an opportunity to standardize and improve patient SDOH data collection to assist stakeholders in addressing non-clinical needs that impact health outcomes and costs.
Milbank Memorial Fund: (11/23) - Electronic health records (EHRs) are subject to implicit bias in its design, which can perpetuate and amplify biases over time and across users if left unchecked. EHRs can be designed to challenge implicit biases of their users, but this is unlikely to happen unless incentivized through innovative policy. This article offers a conceptual model that has potential to redefine and improve the value of technology to health by modifying EHRs to support more equitable data that can be used for better patient care and public policy.
Mobi Health News: (11/16) - BroadReach Group announced a new cloud-based platform aimed at tackling health equity challenges, called Vantage Healthcare Technologies. The tool is designed to help health care organizations to pinpoint underserved communities and bolster COVID-19 testing and vaccination, as well as find coding issues that lead to incomplete medical histories.
Health IT Analytics: (11/15) - Researchers at the University of California used patient data analytics to determine if race and ethnicity-based COVID-19 outcomes disparities are associated with socioeconomic characteristics. The researchers found that Black and Hispanic populations were the most likely to test positive for COVID-19, and Asian Americans had the highest risk of intensive care unit admission.
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 firstname.lastname@example.org