The Rise of Health-Related Social Needs in Health Care
This post was written by Sarah Dunbar, Consultant.
The growing policy and state momentum around health-related social needs (HRSN) warrants a deeper dive into the opportunities available across the health care continuum. Let us unpack what they are, current innovative approaches to addressing HRSNs, and the emerging opportunities for providers and social care providers.
Why the Growing Interest?
The growing interest in social needs, health-related social needs (HRSNs), social drivers of health, or social determinants of health (SDOH), continues to focus on the variables that affect an individual's health and how health care alone cannot solve all health care-related issues. Focus on addressing HRSNs continues to be a primary concern among managed care organizations, health care providers, and social care providers, with a significant focus on operationalizing interventions and minimizing health equity gaps.
The recently approved NYS 1115 waiver demonstration is a nod to this continued focus on HRSN. New York is one of eight states that have approved waiver programs with HRSN-related provisions. Interest in NY continues to grow as stakeholders patiently await the approval of social care networks and additional details on how services will be paid for and delivered at the ground level.
There has been a slow but distinct change in the use of SDOH and HRSN in the past few years. So, what exactly are HRSNs, and how do they differ from SDOH? Social determinants of health refer to the conditions in the environment where people are born, work, live, and age. These community-level factors affect a wide range of health and quality-of-life outcomes. HRSNs are individual manifestations of SDOH. Specifically, the economic and social needs that individuals experience jeopardize their ability to maintain and improve their health. Finally, social drivers of health is a more extensive umbrella term encompassing both SDOH and HRSNs.
What Are the Current Realities?
While CMS is dedicated to addressing HRSNs through the 1115 Waiver Demonstrations and CMMI models, the challenge of implementing actionable strategies at the ground level continues to be a reality for public health agencies, healthcare delivery systems, and downstream providers. Health plans are now tasked with paying for and providing/managing certain HRSN services. This work has to be driven by strong partnerships between payers and public health systems that break down the silos, allowing each to do their part in helping the overall well-being of these individuals and communities.
While SDOH interventions are not new, many are taking innovative approaches to delivering HRSN interventions. Oregon recently announced that it will be shipping air conditioners, purifiers, and power banks to vulnerable residents to prevent the potentially deadly health effects of heat, wildfire smoke, and other climate-related disasters. While at least 20 states already direct Medicaid funding towards housing and nutrition services, Oregon is the first to use these funds to pay for climate-related costs
What Does the Future Hold?
While providers and CBO stakeholders have many opportunities, many hurdles remain to be overcome.
Standardized tools do not fit every population. How will states and payers develop tools for specific populations, such as those with developmental disabilities?
Data collection, storage, and evaluation are needed to address critical issues.
Streamlined referral and follow-up among all parties are necessary
Leveraging community relationships and trust is the key to seeing results that will not be immediate.
If Oregon indicates the future, we should all be excited to see what states like NY will have in store. Will NY seek to implement climate-related interventions to drive specific community outcomes? Who knows? However, we look forward to seeing more relationships with CBOs, providers, and payers.
If you are interested in the NYS 1115 waiver and the specific HRSN provisions included in the waiver amendment, check out our 1115 waiver page or reach out to us directly!
About the Author: Sarah Dunbar is a Consultant at Helgerson Solutions Group. Connect with her on LinkedIn.
