AIS Health: Reporter’s Notebook: Social Determinants of Health Are Critical to the Future of Medicaid

Reporter’s Notebook: Social Determinants of Health Are Critical to the Future of Medicaid

Reprinted with AIS Health’s permission from the November 1, 2018, issue of Radar on Medicare Advantage

As health care industry leaders last month convened at two major Medicaid-focused conferences in Washington, D.C., one issue that repeatedly came up in conversations about Medicaid’s future was the program’s role in addressing social determinants of health. Here are what some of the experts had to say:

“Is it Medicaid’s job to address those? Directly, no. But it is Medicaid’s role and obligation and purpose to produce better health outcomes…and I think we could all argue that you’re not going to get there without somebody addressing these various social determinants of health. We’re not going to be able to pay for them directly — I don’t know that we should be responsible for doing it — but quite frankly, nobody else is going to do it….We’re going to have to figure out how are we getting those services to people and I think the biggest question we’re going to have is how do we take the conversation around social determinants, which is at its core an extraordinarily personal kind of interaction, and turn that into public policy?” — Matt Salo, executive director, National Association of Medicaid Directors, at the America’s Health Insurance Plans (AHIP) National Conference on Medicaid on Oct. 17

“When we talk about social determinants of health, I don’t see it as a separate from solving physical, behavioral or pharmacy [issues]....It’s not enough just to fund community programs that help expand food pantries or help with utility assistance or transportation, but you also have to see the impact that solving or closing a social gap has on the individual….When [providers] can’t help [members] with a medical issue because a social issue is impacting their lives, being able to offer a service to that member [e.g., meals for a diabetic member] and our ability to measure and show the impact of that is really powerful. I would say that social determinants is a top priority for us and it needs to be top priority for all states.” — Kelly Munson, executive vice president, Medicaid, WellCare Health Plans, Inc., at the Medicaid Health Plans of America Annual Conference on Oct. 22

“Through Medicaid, we protect and empower [low-income] individuals, especially the children and the disabled. For many of them, nutritious food, shelter, transportation and safety have become luxuries. If most of these people have a choice, I am certain that…they would rather be self-sufficient, but they are not for legitimate reasons. Many social determinants create situations that are out of their control and leave them without essential resources. So when we talk about the future of Medicaid, we must also talk about the future of poverty in our country. They are inextricably linked, especially as the poverty level remains in double digits.” — Paul Tufano, chairman and CEO, AmeriHealth Caritas Family of Companies, at AHIP on Oct. 17

by Lauren Flynn Kelly

Article from AIS Health