Summary
In recent years, the Department of Health and Human Services (HHS) has advanced toward a greater recognition of the social determinants of health in federal health coverage programs, via expanded non-clinical benefit offerings, meaningful quality measures and the like. As HHS continues along a trajectory of advancing value-based payment, opportunities persist to expand the focus on addressing non-health care needs that ultimately impact individuals’ overall health and the total cost of care.
In the attached issue brief, the Wynne Health Group provides an overview of the growing recognition of social determinants of health as an important tool to address population health and bring down costs in federal health coverage programs. We discuss existing opportunities through which the federal government and states are able to positively impact social determinants of health factors for beneficiaries enrolled in Medicare fee-for-service (FFS); Medicare Advantage (MA); Medicaid and the Children’s Health Insurance Program (CHIP); as well as through Centers for Medicare and Medicaid Innovation (CMMI) pilot projects. Additionally, we outline what’s on the horizon by looking ahead to potential regulatory levers the Trump Administration may use to either advance or, arguably in some cases, diminish social determinants of health in these critical programs.