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July 29, 2019

How a first-of-its-kind bipartisan bill would address social determinants

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    A bipartisan group of House lawmakers on Thursday introduced a bill that would create a multi-agency council, as well as a $25 million federal fund, to address the social determinants of health.

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    According to Modern Healthcare, the bill is the first federal legislation specifically focused on addressing the social determinants of health.

    Bill details

    Reps. Tom Cole (R-Okla.), Jim McGovern (D-Mass.), and Cathy McMorris Rodgers (R-Wash.) unveiled the bill, called the Social Determinants Accelerator Act. The measure aims to help communities and states develop strategies to use existing programs to improve the health and well-being of Medicaid beneficiaries. Specifically, the bill would provide state, local, and Tribal governments with technical assistance and planning grants to develop innovative and evidence-based approaches to boost the cost-effectiveness of current programs, coordinate services for Medicaid beneficiaries, and improve beneficiaries' health outcomes.

    Under the bill, HHS would convene an inter-agency technical advisory council on the social determinants of health consisting of officials from:

    • The Department of Agriculture;
    • The Department of Housing and Urban Development;
    • The Department of Labor;
    • Private sector and community-based organizations; and
    • State and local governments.

    The council would provide states and local governments with technical assistance by identifying opportunities and strategies for governments to combine funds for their programs and develop rigorous evaluations for the programs. The council would release best practices and opportunities for cross-program coordination to ensure all jurisdictions can benefit from the council's support.

    CMS under the bill would consult with the council to distribute up to $25 million in grants for state, local, and Tribal governments to help them develop so-called "Social Determinants Accelerator Plans." The plans would:

    • Establish key outcomes for the use of evidence-based interventions and the coordination of health and non-health services;
    • Link data across programs to measure how newly implemented approaches have affected the health of Medicaid plan participants and return-on-investment for taxpayers; and
    • Target high-need Medicaid beneficiaries, including homeless individuals, women diagnosed with post-partum depression, nursing home patients, and older workers with arthritis.

    According to Modern Healthcare, up to 20% of the funds would be earmarked for beneficiaries who live in rural regions.

    Bill has industry support

    The Aligning for Health coalition—which includes the American Hospital Association (AHA), the Blue Cross and Blue Shield Association, Humana, Molina Healthcare, and UPMC—supports the bill.

    AHA President Tom Nickels said, "The Social Determinants Accelerator Act would better align resources to improve outcomes within the Medicaid program by funding planning grants for public and private sector accelerator programs, and convening an inter-agency technical advisory council on social determinants of health." He added, "Hospitals and health systems recognize that addressing social determinants of health is central to driving value and advancing overall well-being. We look forward to working with Congress in our efforts to keep our communities healthy" (Luthi, Modern Healthcare, 7/25; Japsen, Forbes, 7/25; Social Determinants Accelerator Act one pager, 7/25).

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