Tight Budgets Slow Medicaid Plans Pursuit Of Social Determinants Of Health
Health plans that contract with state Medicaid programs are moving to address social determinants of health by paying for affordable housing, food vouchers to purchase fresh vegetables and education screenings at the doctor’s office.
But challenges remain from inadequate funding to the lack of data sharing between medical care providers, insurers and community organizations, a new report from the nonprofit The Institute for Medicaid Innovation shows.
“Despite the increasing focus shown in our report on the role of social determinants on health care and outcomes, more needs to be done to create systems to address unmet social needs, especially finding sustainable funding to support these programs,” The Institute for Medicaid Innovation’s executive director, Jennifer Moore, said in a statement accompanying the report called “Innovation and Opportunities to Address Social Determinants of Health in Medicaid Managed Care.”
The report comes as medical providers, insurers and policymakers including high-ranking officials in the Trump administration increasingly see the need to address social determinants of health as a way to improve healthcare and reduce costs. Supporters of spending on ways to address social determinants reason “non-medical factors” of patients like their “housing, education, food insecurity, and poverty can adversely affect population health,” the report says.
There are more than 70 million Americans covered by Medicaid thanks in part to the expansion of such benefits under the Affordable Care Act. Nearly 70% of these Medicaid beneficiaries have their care managed by health plans operated by dozens of health plans including Aetna, Anthem, Centene, Cigna, Molina Healthcare, UnitedHealth Group and most Blue Cross and Blue Shield plans.
There are many emerging success stories. And here are some outlined in the report such as:
- AmeriHealth Caritas DC’s “food as medicine” initiative. The Medicaid health plan has a partnership “with several community-based organizations to improve access to nutritious meals,” the Institute’s report says. “The approach includes vouchers to community farmer’s markets, as well as meal delivery to address client-specific chronic conditions such as pre-diabetes, diabetes, or hypertension.”
- The North Carolina Department of Health and Human Services requires Medicaid health plans in contracts with the state to “to adopt standardized social needs screening beginning in mid-2019 as part of their care management strategies.” The information is then shared with the Medicaid health plan enrollee’s primary care providers.
- Upper Peninsula Health Plan’s “Connected Communities for Health” initiative which works to address enrollees social determinants of health by working with community, state, faith-based and other organizations to meet patient needs. “Members are screened by customer service representatives for needs in the areas of adult education, childcare, commodities (e.g. household goods/furniture, baby supplies, clothing), employment, finance, food, housing, legal services, transportation, and utility assistance,” the report says.