While the research is settled that social determinants – the conditions in which people are born, grow, live, work, and age – play an important role in health, the related policies are still in development. Addressing the social determinants of health (SDOH) could help bend the cost curve and improve care – the goal of many policymakers. But early efforts to improve quality and lower costs by addressing the SDOH have focused on high-need, high-cost populations. Children’s coverage is typically inexpensive, and quality outcomes may take longer to materialize, making innovation for pediatric care a lower priority for states and the federal government.
But affordable housing, economic security, safe neighborhoods, and access to adequate and healthy foods are major factors that impact the health of low-income children and families every day. And Medicaid could help.
Our new brief outlines ways Medicaid could be leveraged to address the SDOH for children and families by expanding optional benefits like case management, reforming payment and delivery systems to focus on value/quality instead of volume/quantity, integrating applications and eligibility systems to include health and non-health services, and adopting Bright Futures. The brief also describes how improving socioeconomic and health data systems and integration could help in payment and delivery system reform efforts targeting SDOH. Finally, the brief highlights a framework for Medicaid and other health organizations to address SDOH that could serve as a model for future work.
Health advocates can play an important role by identifying ways to address the SDOH and improve care for children and their families, where early investments can lead to long-term results including greater economic success and independence as adults.
