AHIP Signs onto Support for Social Determinants Accelerator Act

January 14, 2020 - The America’s Health Insurance Plans (AHIP) recently espoused the Social Determinants Accelerator Act and urged a hearing to discuss how it might help the healthcare industry’s fight against social determinants of health barriers.

“We believe that the Social Determinants Accelerator Act is a critical step to overcome these challenges and move the ball forward,” the letter read. “It will provide state, local and tribal governments with additional capacity and support to incubate innovative strategies – and the entire nation will benefit from the results of their effort.”

The Social Determinants Accelerator Act (H.R. 4004), which is currently pending in the House of Representatives, seeks to empower the healthcare system to address social determinants of health more effectively. 

The Act looks to provide federal assistance to state and local governments to build effective health and social services programs. It calls on state and local governments to distinguish any federal barriers to addressing social determinants of health. And, lastly, the Act’s goal is to establish these policies and strategies while not overlooking vulnerable populations and limiting their access to care.

This could be achieved by setting up a Social Determinants Accelerator Interagency Council. This body, consisting of representatives from the nation’s healthcare agencies, would submit an annual report to Congress on social determinants of health, summarizing state, local, and tribal strategies from that year.

They are also to advise the HHS Secretary and CMS Administrator, provide assistance to states looking to develop a social determinants accelerator plan, conduct an annual survey for feedback from state, local, and tribal governments regarding the council’s assistance, serve low-income and at-risk populations in coordination with other agencies, and more.

“In addition to local-level leadership, the federal inter-agency technical advisory council created by the Act would identify key learnings and best practices, allowing for the scaling and replication of effective approaches, and facilitate a national dialogue around barriers to success of these initiatives,” the letter explained.

Should the Act come to fruition, Social Determinants Accelerator Grants would be made available to state and local governments to help develop a social determinants of health plan. The Act sets aside $25 million for these grants.

AHIP is not alone in its support. It signed the letter as a member of Aligning for Health, a healthcare industry association comprised of the nation’s leading medical groups including payers such as Humana, Centene, Blue Cross Blue Shield Association, and the Health Care Service Corporation (HCSC). It formed early in 2018 to tackle social determinants of health issues. 

“States are increasingly looking to deploy social determinants of health interventions to manage costs and improve health outcomes within their Medicaid programs. However, one of the greatest challenges to high impact interventions is the difficulty in navigating and coordinating fragmented and complex programs aimed at addressing healthcare needs, food insecurity, housing instability, workforce supports, and transportation reliability, among others,” Aligning for Health explained in a one-pager on the Act.

Aligning for Health went on to explain that states might use the CMS grants to target specific Medicaid populations, discover the outcomes of different coordinated care models as well as non-clinical, data-driven actions, and consolidate data across agencies so that there is no duplication.

The role of payers in addressing the social determinants of health has been both developing and, at times, contentious.

Major payers like UnitedHealthcare and Cigna have poured hundreds of millions of dollars into addressing social determinants of health barriers. 

Some argue that these investments, however, have no accountability. Funding injections cannot ensure a healthy, long-term program and may not result in tracking outcomes.

With the Social Determinants Accelerator Interagency Council, some of these concerns might be assuaged. If the agency functions as intended, it would be a unifying and communicative presence in the industry, whose primary goal is to keep a finger on the pulse of social determinants of health across the nation and ensure that investments are being used effectively.

Cost-benefit analyses and fractured coordination are other typical barriers that the council would, ideally, help address.