While the introduction of the proposed Medicaid Fiscal Accountability Rule (CMS-2393-P) grabbed headlines at last week’s National Association of Medicaid Directors (NAMD) Fall Conference, discussions about Social Determinants of Health could also be considered front-page news.
Throughout the country, state and local governments are developing and administering programs aimed at addressing the barriers to good health such as housing and food insecurity, access to quality care, and limited social interaction.
There are several programs that have already demonstrated positive outcomes, and an example of this was brought to life at the conference by learning about a man living in the greater Phoenix area. Elizabeth daCosta, Senior Director of Housing and Community Integration, Community Bridges, Inc., reviewed the timeline during which the gentleman was identified as needing assistance, located, and began receiving assistance with overcoming the barriers he faced in returning to good health. While the gentleman was not in attendance, we saw him in a series of photos, and Ms. daCosta did an excellent job of bringing his story to life.
During her opening plenary address, Seema Verma, Administrator, Centers for Medicare and Medicaid Services, stressed the fact that while these programs and pilots are yielding very good results, they are only addressing the needs of a small fraction of Medicaid-eligible individuals. She called for a major expansion of these initiatives throughout the country in order to improve health and contain costs.
As we look at examples such as the one in Phoenix, we can learn from their successes and work to ensure that the same processes exist countrywide. First and foremost, it is very apparent that the hard work and dedication of the staff in programs such as Community Bridges is the most important ingredient. However, technology and the availability of data cannot be overlooked. It was through the interoperability of key databases, medical alert systems, and the network of community services that support the homeless and others that Community Bridges was able to locate the individual that needed help. Even with the best of technology, this can take weeks and even months to accomplish.
Personally, I walked away from the conference with a much greater appreciation for how Social Determinants of Health have an important impact on the health status of the population. I was also encouraged by the commitment of CMS to expand existing programs and develop new ones. Finally, I encourage everyone to learn more about this subject.
There is no doubt that Social Determinants of Health is gaining momentum as local communities take a more holistic approach toward healthcare.