Recently there has been increasing recognition of the importance of social determinants of health. A growing number of initiatives are emerging to address these broader determinants of health and develop integrated solutions within the context of the health care delivery system. In particular, a number of efforts to link health care to broader social needs are emerging through many Medicaid delivery and payment initiatives.
Kaiser Family Ffoundation: Issue Brief Nov 04, 2015
Harry J. Heiman and Samantha Artiga
Efforts to improve health in the United States have traditionally looked to the health care system as the key driver of health and health outcomes. The Affordable Care Act (ACA) increased opportunities to improve health by expanding access to health coverage and supporting reforms to the health care delivery system. While increasing access to health care and transforming the health care delivery system are important, research demonstrates that improving population health and achieving health equity also will require broader approaches that address social, economic, and environmental factors that influence health.
Recently there has been increased recognition of the importance of these factors to health. Moreover, the ACA includes provisions to help bridge health care and community health. It provides for enhanced focus on prevention and primary care, including the creation of the National Prevention Council and a National Prevention Strategy; support for testing and spreading of new delivery and payment arrangements; initiatives to foster increased workforce diversity, and a new requirement for not-for-profit hospitals to conduct community health needs assessments. Reflecting the increased focus and new opportunities provided under the ACA, a growing number of initiatives are emerging at the national, state, and local level to address broader determinants of health. Given Medicaid’s longstanding role serving a diverse population with complex health, behavioral, and social needs, efforts to address social determinants of health are emerging through many Medicaid delivery and payment initiatives. This brief provides an overview of the broad factors that influence health and describes emerging efforts to address them, including initiatives within Medicaid.