Robust efforts to address the social determinants of health (SDOH) are a critical component of comprehensive health reform. As a Coalition dedicated to plan design innovation, we have undertaken an effort to think creatively about the existing intersection of health plan benefits and SDOH. In many markets, especially Medicaid managed care and Medicare Advantage, there is significant interest in addressing SDOH in order to control total cost of care and improve health outcomes. There are, however, limitations to the health care industry’s approach to SDOH. Thus far, plans have taken innovative strides to address piecemeal social needs of individuals but any number of regulatory, statutory, and practical limitations persist.

Click here to view the Smarter Health Care Coalition’s one-pager on SDOH.

Recent Updates

The Intersection of Benefit Design, Social Determinants of Health, And COVID-19 Response
On June 26, 2020, the Coalition released a white paper categorizing the opportunities, challenges, and potential policy recommendations that would facilitate a health plan’s ability to address social needs. One major issue belies this effort and may be the focus of future thought leadership: there are limited funding streams dedicated to addressing social needs, let alone more complex SDOH at the community level. This white paper asks more questions than it answers and we will continue to investigate ways to improve, when appropriate, the intersection of SDOH and benefit design.