Medicaid, Medicare making the move toward social determinants
=============================================================

* Lindsey Wahowiak

A new policy could have dramatic and lasting effects on public health, as a major government program takes a turn toward addressing social determinants.

In January, the Centers for Medicare and Medicaid Services announced the first CMS Innovation Center pilot project, called the Accountable Health Communities Model, which will test how patients’ health can be improved by addressing social and environmental needs. The U.S. Department of Health and Human Services will oversee the five-year test with an investment of $157 million to bridge care with social services.

The Accountable Health Communities Model will award funds to up to 44 “bridge organizations” to screen people for issues related to social determinants of health, and to refer those people to community organizations that can help them meet their needs, aligning clinics with the nearby organizations already working to address and conquer factors that can affect health. Bridge organizations will take inventory of the services available to local people and provide community referral, community service navigation and community service alignment for their patients.

For example, if people are not taking their prescribed medications because they do not have transportation to get to a pharmacy, health care providers will be able to connect them with community organizations that address transportation issues, as well as state and federal programs to help them access their medication, according to HHS.

“We recognize that keeping people healthy is about more than what happens inside a doctor’s office,” said HHS Secretary Sylvia Burwell in a news release. “That’s why, for the first time, we are testing whether screening patients for health-related social needs and connecting them to local community resources like housing and transportation to the doctor will ultimately improve their health and reduce the cost to taxpayers.”

The Accountable Health Communities Model has another benefit: It could reduce the financial burden on state and federal health care budgets by allowing already-existing community support organizations to provide their services to a greater number of people. In January 2015, HHS announced it hoped to shift Medicare reimbursement payments to focus on quality and value payment models, including those made possible by the Affordable Care Act.

Amanda Reddy, MS, director of strategy and impact at the National Center for Healthy Housing, said the scalable model has the potential to ease cost burdens, improve health and promote community relations in a sustainable way. With three levels — basic education offered, education and assistance provided through a navigator and intensive help and follow-up — the model can work in a variety of settings. And it could have a major impact: 3.3 million people are expected to go through the screening in a five-year test.

“It’s a system we can sustain for the long term,” Reddy told *The Nation’s Health.* “If we get this right as a community who is helping to inform CMS…we have the ability to impact not just the health of the people involved, but do nothing short of transforming our health care sector and transforming our communities. That’s the promise of health care reform and we have the ability to deliver on that promise.”

To learn more, visit [http://innovation.cms.gov](http://innovation.cms.gov).

*   Copyright The Nation’s Health, American Public Health Association