Health Leaders: BCBSMA Adds Tufts Medicine to its Pay-for-Equity Payment Model (5/24) – Blue Cross Blue Shield of Massachusetts (BCBSMA), a health plan of the Blue Cross Blue Shield Association, added Tufts Medicine to its equity-focused value-based payment model. As part of the contract, Tufts Medicine will focus on reducing inequities in colorectal cancer screenings, hypertension, diabetes care, and child and adolescent well-care visits. BCBSMA said it is the first health plan in Massachusetts to use these contracts to tie financial incentives to achieving measurable improvements in health equity.
NEJM Catalyst: Breaking Down the Barriers Between Health and Social Care Services – Implementing a Social Determinants of Health Network (5/17) – Healthy Alliance
developed a social determinants of health network (SDHN) in 2018 as a regional strategy to provide health-critical social services in Upstate New York. Three managed care organizations have partnered with Healthy Alliance to improve health outcomes through social care services, leading to the completion of almost 50,000 requests for connections and 28,000 unique community members served. This case study examines these partnerships’ successes, ongoing challenges and key next steps.
NEJM Catalyst: The Impact of SNAP Enrollment on Health and Cost Outcomes (5/17) – This article written by individuals at UPMC and Benefits Data Trust highlights a study conducted using Supplemental Nutrition Assistance Program (SNAP) data from the Pennsylvania Department of Human Services and health care claims data from an integrated health care delivery and finance system. The study reports findings of an innovative collaboration between a health care payer and a nonprofit organization to enroll dual-eligible individuals in SNAP, and contributes to the growing evidence that novel payer-led interventions to address SDOH can influence positive changes in health care utilization and cost reduction, especially among disadvantaged populations.
American Hospital Association: Chair File – Connecting and Collaborating to Advance Health Equity and Improve Community Health (5/15) – Advancing health equity is of utmost importance for those working in hospitals and health systems, and is the topic front and center at the 2023 American Hospital Association
Accelerating Health Equity Conference. This conference brings together professionals focused on improving community and population health and those working to advance diversity, equity and inclusion, including within hospital management and leadership roles. Highlights from the conference can be found here.
Reintroduction of the Black Maternal Health Momnibus Act
On May 15, Reps. Underwood (D-IL) and Adams (D-NC) and Sen. Booker (D-NJ) reintroduced the Black Maternal Health Momnibus Act, a package of legislation to save moms’ lives and address every driver of maternal mortality, morbidity, and disparities in the United States. The Momnibus is made up of 13 bills sponsored by Black Maternal Health Caucus Members. Bill Summary
Rep. Underwood (D-IL) and 181 cosponsors introduced the Black Maternal Health Momnibus Act (H.R. 3305), which would end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States. Sen. Booker (D-NJ) and 27 cosponsors introduced companion legislation in the Senate (S. 1606).
Rep. Sewell (D-AL) and 96 cosponsors introduced the Maternal Vaccination Act
(H.R. 3348), which would amend the Public Health Service Act with respect to maternal vaccination awareness and equity. Sen. Kane (D-VA) introduced companion legislation in the Senate (S. 1603), which would increase vaccination rates of pregnant and postpartum individuals. Press Release
Rep. Schakowsky (D-IL) and 94 cosponsors introduced the Innovative Maternal Payment And Coverage To (IMPACT To) Save Moms Act (H.R. 3346), which would implement the Perinatal Care Alternative Payment Model Demonstration Project to test various payment models with respect to maternity care provided to pregnant and postpartum individuals. Bill TextPress Release
Rep. Hayes (D-CT) and 95 cosponsors introduced the Social Determinants for Moms Act (H.R. 3322), which would address social determinants of maternal health to eliminate maternal mortality, severe maternal morbidity, and maternal health disparities. Sens. Blumenthal (D-CT) and Booker (D-NJ) introduced companion legislation in the Senate (S. 1594), which would convene a task force to develop strategies and coordinate efforts to eliminate preventable maternal mortality. Press Release
Rep. Davids (D-KS) and 97 cosponsors introduced the Data to Save Moms Act (H.R. 3320), which would improve maternal health data collection processes and quality measures. Sen. Smith (D-MN) and Booker (D-NJ) introduced companion legislation in the Senate (S. 1599), which would provide for grants to promote representative community engagement in maternal mortality review committees. Press Release
Reps. Blunt Rochester (D-DE), Fitzpatrick (R-PA), and Underwood (D-IL) introduced the Moms Matter Act (H.R. 3312), which would address maternal mental health conditions and substance use disorders. Sens. Gillibrand (D-NY) and Booker (D-NJ) introduced companion legislation in the Senate (S. 1602). Press Release
Rep. Adams (D-NC) and 98 cosponsors introduced the Kira Johnson Act (H.R. 3310), which would end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes.
Rep. Underwood (D-IL) and 96 cosponsors introduced the Maternal Health Pandemic Response Act (H.R. 3304), which would authorize appropriations for data collection, surveillance, and research on maternal health outcomes during public health emergencies. Sens. Warren (D-MA), Booker (D-NJ), and Gillibrand (D-NY) introduced companion legislation in the Senate (S. 1605).
Reps. Underwood (D-IL), Bilirakis (R-FL), Brownley (D-CA), and Fitzpatrick (R-PA) introduced the Maternal Health for Veterans Act (H.R. 3303), which would provide support for programs of the Department of Veterans Affairs relating to the coordination of maternity health care.
Reps. Underwood (D-IL) and 96 cosponsors introduced the Protecting Moms and Babies Against Climate Change Act (H.R. 3302), which would protect moms and babies against climate change. Sens. Markey (D-MA), Booker (D-NJ), Blumenthal (D-CT), and Sanders (I-VT) introduced companion legislation in the Senate (S. 1601). Press Release
Rep. McBath (D-GA) and 97 cosponsors introduced the Extending WIC for New Moms Act (H.R. 3332), which would extend eligibility for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) for new moms. Sens. Blumenthal (D-CT) and Booker (D-NJ) introduced companion legislation in the Senate (S. 1593). Press Release
Rep. Pressley (D-MA) and 98 cosponsors introduced the Justice for Incarcerated Moms Act (H.R. 3344), which would end the shackling of pregnant individuals and provide funding for programs to create maternal health programs for incarcerated individuals. Bill TextPress Release
Rep. Moore (D-WI) and 95 cosponsors introduced the Perinatal Workforce Act (H.R. 3523), which would grow and diversify the perinatal workforce. Sens. Baldwin (D-WI), Merkley (D-OR), and Booker (D-NJ) introduced companion legislation in the Senate (S. 1710). Press Release
Sens. Menendez (D-NJ), Booker (D-NJ), and Sullivan (R-AK) introduced the Tech to Save Moms Act
(S. 1699), which would support the use of technology in maternal health care. Bill TextPress Release
Pursuing Equity in Mental Health Act (5/19) – Sen. Menendez (D-NJ) and Reps. Watson Coleman (D-NJ) and Napolitano (D-CA) introduced the Pursuing Equity in Mental Health Act (H.R. 3548/S. 1700), which would authorize $995 million in grants and other funding to support research, improve the pipeline of culturally competent providers, build outreach programs that reduce stigma, and develop a training program for providers to effectively manage disparities.
Senior Hunger Prevention Act (5/18) - Rep. Bonamici (D-OR) and 20 cosponsors introduced the Senior Hunger Prevention Act (H.R. 3474), which would streamline nutrition access for older adults and adults with disabilities.
RESTORE Act (5/18) - Reps. Cohen (D-TN) and Rutherford (R-FL) introduced the Re-Entry Support Through Opportunities for Resources and Essentials (RESTORE) Act (H.R. 3479), which would allow individuals with drug offenses to receive benefits under SNAP. Sen. Booker (D-NJ) and six cosponsors introduced the companion legislation in the Senate (S. 1753).
HELP Act (5/18) - Reps. Higgins (D-NY) and Fitzpatrick (R-PA) introduced the Human Services Emergency Logistics Program (HELP) Act (H.R. 3498), which would facilitate nationwide accessibility and coordination of 211 services and 988 services in order to provide information and referral to all residents and visitors in the United States for mental health emergencies, homelessness needs, and other social and human services needs. Sen. Casey (D-PA) and 13 bipartisan cosponsors introduced the companion legislation in the Senate (S. 1729).
Rep. Budzinski: Budzinski, Jackson Urge Administration to Focus on Food Access (5/16) - Reps. Budzinski (D-IL) and Jackson (D-IL) sent a letter
to Department of Agriculture Secretary Vilsack advocating that additional resources be made available to communities struggling to maintain access to healthy and affordable food options.
No Surprise Bills for New Moms Act (5/16) - Rep. Porter (D-CA) and seven bipartisan cosponsors introduced the No Surprise Bills for New Moms Act (H.R. 3387), which would provide for certain health coverage of newborns. The bill would automatically cover newborns for the first 30 days and create a standardized 60-day enrollment period for infant health insurance.
HEADs UP Act (5/16) - Reps. Moulton (D-MA), Fitzpatrick (R-PA), Dingell (D-MI), and Morelle (D-NY) introduced the Healthcare Extension and Accessibility for Developmentally Disabled and Underserved Population (HEADs UP) Act (H.R. 3380), which would expand and improve health care services by health centers and the National Health Service Corps for individuals with a developmental disability.
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.
The CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) announced the availability of funds to state, local, territorial, and tribal jurisdictions that are ready to take ACTion (Addressing Conditions To improve population health) in communities to implement policy, systems, and environmental change (PSE) interventions that address Social Determinants of Health (SDOH) to reduce chronic disease related disparities, risk factors, and inequities.
Changes in group and organization behavior and norms
Adoption of new policies and practices
Changes in availability and accessibility of health care and community services.
Five applicants are expected to be funded to complete three-year ACTion projects focused on implementing established plans that include PSE interventions in one of four SDOH domains. Awards will be up to $500,000 per applicant each year. Applications are due June 30, 2023.
HHS: HHS Releases Report to Increase Language Access for Persons with Limited English Proficiency (5/24) – The HHS Office for Civil Rights released a report
summarizing the progress HHS has made on improving the provision of meaningful access to language assistance services to persons with limited English proficiency (LEP). The report also identifies steps to continue and strengthen this work across HHS moving forward.
CMS: Disparities in Health Care In Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability Stratified Report (5/23) – The CMS Office of Minority Health published a report detailing the quality of care received by people enrolled in Medicare Advantage (MA). The report presents summary information on the performance of MA plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of MA enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability.
HHS: HHS Announces Over $65M to Address the Maternal Health Crisis and Invest in New Approaches to Care (5/19) – The Health Resources and Services Administration (HRSA) awarded more than $65 million to 35 HRSA-funded health centers in medically underserved and rural communities to address the maternal mortality crisis. The funds will be used to implement innovative approaches to improve maternal health outcomes and reduce disparities for patients at highest risk.
White House: Biden-Harris Administration Announces New Initiative to Tackle Unsheltered Homelessness (5/18) – The Biden Administration announced the launch of ALL Inside, a first-of-its-kind initiative to address unsheltered homelessness across the country. Through the ALL INside initiative, the U.S. Interagency Council on Homelessness (USICH) and its 19 federal member agencies will partner with state and local governments to strengthen and accelerate local efforts to get unsheltered people into homes in six places: Chicago, Dallas, Los Angeles, Phoenix Metro, Seattle, and the State of California.
Administration for Community Living (ACL): ACL Awards Cooperative Agreements to Support Innovations in Nutrition Programs and Services (5/18) - ACL announced that 12 Innovations in Nutrition Programs and Services (INNU) grants were awarded for the 2023 grant year to support the Older American Act (OAA) Title III-C Nutrition Services program, working to reduce food insecurity, enhance socialization, and promote health and well-being of older adults.
ACL: I/DD Counts National Summit Report Highlights Health Data as Equity Issues (5/18) - ACL released a report
on key ideas and recommendations for the Intellectual and Developmental Disabilities (I/DD) Counts Initiative, following a stakeholder summit. The reports highlights health data as a key equity issue, and outlines discussion themes on the initiative’s 2030 roadmap for health data equity, remaining gaps, and priorities for the future.
USDA: USDA Funds 36 Projects Aimed at Connecting Families to WIC through Partnership with FRAC as part of Investing in America Agenda (5/18) – The U.S. Department of Agriculture (USDA), through a cooperative agreement with USDA’s Food and Nutrition Service (FNS), has awarded $16 million in subgrants funding from the American Rescue Plan Act to 36 projects aimed at testing innovative outreach strategies to increase participation and equity in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The WIC Community Innovation and Outreach Project subgrantees include WIC state and local agencies and community-based organizations, including four led by tribal nations or entities.
CMS: Accountable Health Communities (AHC) Model Evaluation – Second Evaluation Report (5/17) - CMS released the second evaluation report of the Accountable Health Communities (AHC) Model. AHC bridge organizations screened more than one million Medicare and Medicaid beneficiaries through December 2021. Nearly 40 percent of screened beneficiaries had at least one health-related social need (HRSN); about half of beneficiaries with HRSNs (almost 20 percent of those screened) also had two or more ED visits during the year before screening and were eligible for navigation. Findings to date indicate that the model did not markedly increase beneficiaries’ connections to community services or HRSN resolution, suggesting that navigation alone may not be sufficient to address HRSNs.
GAO: Homelessness – Enhanced Coordination Could Improve Disaster Shelter and Housing Assistance (5/16) – The Government Accountability Office (GAO) published a study examining two federal agencies – the Department of Housing and Urban Development (HUD) and Federal Emergency Management Agency (FEMA) – that provide funding to state and local governments that can help assist the homeless population during a disaster. However, HUD and FEMA don’t regularly work together on homeless housing issues during disasters. This report recommends the agencies do so more efficiently and effectively to assist this population.
National Institutes of Health (NIH): NIH-funded study highlights financial toll of health disparities in the United States (5/16) - NIH released a press release highlighting a recent study
by the National Institute on Minority Health and Health Disparities which found that racial and ethnic health disparities cost the U.S. economy $451 billion in 2018. This is a 41 percent increase from the previous estimate of $320 billion in 2014. The study also finds that the total burden of education-related health disparities for persons with less than a college degree in 2018 reached $978 billion, about two times greater than the annual growth rate of the U.S. economy in 2018.
SDoH & Health Equity in the News
Benefits Data Trust: Creating More Efficient Access to Benefits for Families – A Q&A with Two State Leaders Driving Change (5/23) – Benefits Data Trust (BDT) is working with North Carolina and the state of Washington to pursue comprehensive improvements to their benefits systems through ambitious goals to increase program participation and simplify access. The agencies leading this work in North Carolina and Washington recently released detailed action plans to create systems that provide dignified, efficient, and proactive assistance. This article features a Q&A with two leaders in these efforts.
STAT: Checklists to screen for patients’ social needs aren’t helping (5/22) – In recent years, providers have started to ask patients about a manner of topics related to social needs, but these efforts have manifested themselves in the form of a rapid “screen-and-refer” approach, which involves asking patients to quickly complete checklists about their social needs and then automatically refer them to social service organizations. While this approach has become increasingly popular at hospitals and clinics, implementation is often flawed and overwhelms the very organizations meant to provide support, and can be unintentionally harmful to patients.
Health Affairs: Moving From Incremental to Transformational Strategies to Address Health-Related Social Needs (5/18) – Two recent analyses of data from the CMS Innovation Center Accountable Health Communities (AHC) Model show both that navigation had impressive effects on health-related social needs and that AHC did not go far enough. Effective navigation needs to be person-centered, including more active and long-term approaches that support every step necessary to address an individual’s needs and priorities, rather than merely an enhanced referral mechanism. As critically, the social service sector requires significantly more resources if it is to have sufficient capacity to meet demand and the ability to partner meaningfully with health care providers and payers.
Health Affairs: Why Current ‘Food is Medicine’ Solutions Are Falling Short (5/12) – The movement to address ‘food is medicine’ is growing in popularity in health care, however there remain fundamental problems in our food system and approach to health and nutrition interventions that impede progress of sufficient haste and breadth. This article discusses five major food problems that are impeding the effectiveness of this movement and strategic plan.
New Research and Reports
Duke Margolis Center for Health Policy: Community Health Workers Key to Advancing Health Equity (5/23) – Community health workers are frontline public health workers who are trusted members of and/or have a close understanding of the community they serve. This paper
outlines policy recommendations to enhance and prioritize community health worker care models and amplify their impact on health equity into existing health care transformation reforms. The policy brief synthesizes experiences from the Rapid Acceleration of Diagnostics – Underserved Populations (RADx-UP) projects during COVID-19 and identified policy changes that prioritize community health workers in payment and care delivery reforms.
Health Affairs: Addressing Health-Related Social Needs Via Community Resources: Lessons from Accountable Health Communities (5/17) – The authors of this study surveyed a subset of Accountable Health Communities (AHC) Model beneficiaries with one or more health-related social needs and two or more emergency department visits in the prior 12 months to assess their use of community services and whether their needs were resolved. Survey findings indicated that navigation—connecting eligible patients with community services—did not significantly increase the rate of community service provider connections or the rate of needs resolution, relative to a randomized control group.
Health Affairs: Health Care Impacts of Resource Navigation for Health-Related Social Needs in the AHC Model (5/17) – This study used data from 2015 through 2021 to test whether the AHC Model had impacts on health care spending and use. Findings show statistically significant reductions in emergency department visits for both Medicaid and fee-for-service Medicare beneficiaries. Interviews with AHC Model participants who were offered navigation services to help them find community-based resources suggested that navigation services could have directly affected the way in which beneficiaries engage with the health care system, leading them to be more proactive in seeking appropriate care.
BMC Public Health: Multimorbidity and SDOH in the US prior to the COVID-19 pandemic and implications for health outcomes (5/15) - Multimorbidity increases the risk of all-cause mortality, and along with age, is an independent risk factor for severe disease and mortality from COVID-19. Inequities in the social determinants of health contributed to increased mortality from COVID-19 among disadvantaged populations. This study aimed to evaluate the prevalence of multimorbid conditions and associations with the social determinants of health in the US prior to the pandemic.
JAMA Network Open: Neighborhood Deprivation and Association with Neonatal Intensive Care Unit Mortality and Morbidity for Extremely Premature Infants (5/11) – This study looked to see if socioeconomic deprivation at the neighborhood level, measured by an Area Deprivation Index (ADI), is an independent risk factor for neonatal intensive care unit (NICU) mortality and morbidity among extremely premature infants. ADI percentile was associated with the risk of NICU mortality and morbidities after adjusting for multiple covariates. Findings have implications for targeting areas of neighborhood deprivation to improve prenatal care.