scholarly journals Perspectives on Opportunities and Challenges for Medicare Advantage Plans to Address Social Determinants of Health via the CHRONIC Care Act

2019 ◽  
Vol 56 ◽  
pp. 004695801986212
Author(s):  
Melony E. Sorbero ◽  
Ashley M. Kranz
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Chronic Care ◽  
Chronically Ill ◽  
Determinants Of Health ◽  
Medicare Advantage ◽  
Eligibility Criteria ◽  
Funding Sources ◽  
First Time

There is increasing recognition of the role of social determinants of health (SDOH) in the ability of Medicare Advantage (MA) enrollees to obtain needed care. The 2018 CHRONIC Care Act established Special Supplemental Benefits for the Chronically Ill (SSBCI), which for the first time gives MA plans the flexibility to provide supplemental benefits to enrollees to address SDOH. Given the role of SDOH in chronic disease, this represents an opportunity for MA plans to address underlying issues not strictly health care related with which MA enrollees struggle and that affect their overall health. MA plans have experimented with different approaches to address SDOH but have been limited by the lack of ability to offer services as part of covered benefits and reliance on partnerships, grants, and other funding sources to support the provision of these services. The effect of this policy and how it may evolve before implementation begins in 2020 remains uncertain as we wait to see how MA plans will interpret eligibility criteria and services offered without any additional allotted funding.

scholarly journals Perspectives of Medicare Advantage Plan Representatives on Addressing Social Determinants of Health in Response to the CHRONIC Care Act

2019 ◽  
Vol 2 (7) ◽  
pp. e196923 ◽  
Author(s):  
Kali S. Thomas ◽  
Shayla N. M. Durfey ◽  
Emily A. Gadbois ◽  
David J. Meyers ◽  
Joan F. Brazier ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Chronic Care ◽  
Determinants Of Health ◽  
Medicare Advantage

scholarly journals Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

2021 ◽  
Author(s):  
Bo Burström
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Healthcare System ◽  
Health Equity ◽  
Social Determinants ◽  
Primary Healthcare ◽  
Communicable Diseases ◽  
Determinants Of Health ◽  
Non Communicable Diseases

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

Commissioning and social determinants: evidence and opportunities

2020 ◽  
pp. 269-282
Author(s):  
Chris O’Leary ◽  
Chris Fox
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Local Area ◽  
Determinants Of Health ◽  
Purchasing Power ◽  
Local Authorities ◽  
The Social ◽  
The Uk ◽  
Conceptual Confusion

This chapter argues that local authorities can and should use their purchasing power strategically to address the social determinants of health that affect their local area. It examines commissioning and procurement as local authority functions, defining these concepts and exploring the conceptual confusion between the two. The chapter then looks at the evidence of current practice of local authorities (with a particular focus on local authorities in the UK) in strategic use of their purchasing power. Core to the argument is the role of local voluntary organisations and small and medium-sized enterprises (SMEs), so there is a particular focus on the commissioning experience of these types of organisations. Finally, the chapter makes the case for the role that voluntary sector organisations can play in addressing social determinants of health, before drawing some broad conclusions about the way forward.

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