AFH Applauds the Release of the White House SDOH Playbook

WASHINGTON, DC (November 17, 2023) – Aligning for Health, a leading advocacy coalition focused on improving health through improved coordination of services addressing health and social needs, applauds the White House for publishing the first ever U.S. Playbook to Address Social Determinants of Health. Aligning for Health has long advocated for a comprehensive national plan to address the social determinants of health, through both its engagement with the Administration and bipartisan legislation in Congress — and the playbook represents important progress toward this goal.

Aligning for Health appreciated the opportunity to work with the Administration in developing this pivotal shift in how the U.S. perceives and addresses the nexus of health care and social. We look forward to continuing to support the White House in the implementation of this plan.  Key shared priorities in the plan include (1) enabling appropriate data collection; (2) supporting flexible funding to support health and social need integration; and (3) supporting innovative organizations facilitating this work. The creation of an SDOH Data Working Group, guidance on improving health-related social needs (HRSNs), and integrating supports for underserved populations will advance progress towards better coordinated care and also drive evidence supporting the value of these interventions.

“The release of this Playbook and agency resources is the product of years of work to enhance the efficacy of our health system, improve cost savings for individuals and the federal government, and provide people with the care they deserve,” said Aligning for Health chair Krista Drobac. “We look forward to supporting the Administration to change how we collectively support the health and social needs of Americans at the federal, state, and local level.

Building on this historic announcement, Aligning for Health and RISE will be hosting the White House at the SDOH Policy Forum on December 5 and 6 in Washington, D.C. The conference will also feature bipartisan conversations on how new investments in social needs can increase the government’s return on investment in health and social service programs, as well as improve health outcomes for some of our most vulnerable patients.

Click here for our press release.

 

2023-11-17T18:16:15+00:00November 17th, 2023|Press Release|

AFH Submits Comments on Proposed Physician Fee Schedule

Aligning for Health submitted comments in response CMS’s recently proposed rule from CMS to add a Social Determinants of Health (SDOH) Risk Assessment to Medicare’s Annual Wellness Visit (AWV), which acts as a no-cost annual physician exam for beneficiaries. Pending the outcome of the SDOH Risk Assessment, CMS is also proposing partnerships with community-based organizations to provide Community Health Integration (CHI) and Principal Illness Navigation (PIN) services to beneficiaries.

“Aligning for Health strongly supports the addition of an SDOH Risk Assessment as an optional, additional element of the AWV. Identifying social needs as part of the AWV will allow a practitioner to concurrently evaluate all health and social needs and to work with the beneficiary, consistent with their goals and preferences, to develop a comprehensive plan of care to address any identified needs.”

“Aligning for Health applauds CMS for providing sustainable funding to better connect the health and social services sectors and ensure that funding can flow where the referrals are going to support CHI and PIN services. These investments to connect health care entities and social services organizations can help to reimburse CHWs and CBOs for their time and resources and understand the true cost of, and where such organizations are successful in, addressing basic needs.”

To read our comments, click here or see below:

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2023-09-27T16:23:21+00:00September 18th, 2023|Press Release|

AFH Submits Comments in Response to the Senate HELP Committee Workforce RFI

On March 20, 2023, Aligning for Health submitted comments in response to the Senate HELP Committee Request for Information on the drivers of the current health care workforce shortage. The Committee is seeking feedback to identify bipartisan solutions to remedy the nation’s health care workforce shortages and develop these ideas into legislation.

Identifying and addressing social needs and alleviating the impacts of social determinants of health is critical to improving health outcomes and reducing disparities. Clinicians play a critical role in identifying and helping to develop care plans and make referrals to address social needs. However, clinicians need support in integrating screenings and referrals into workflows without adding burden, and in building relationships and partnerships with critical community connectors that are best suited to assist patients in meeting their social needs.

In our comments, we urge Congress to consider the vital role of community-based providers and entities in bridging gaps in the health care workforce and providing necessary services to address health-related social needs at the community level. Specifically, we provide recommendations around leveraging community health workers to support and enable care in communities, considerations for eligibility and enrollment supports for social safety net programs, and bolstering support for community-based organizations to address the health and social needs of communities.

To read our comments, click here or see below:

Aligning for Health - Senate HELP Committee Workforce RFI - 3.20.23
2023-03-21T20:10:34+00:00March 21st, 2023|Press Release|

AFH Applauds Inclusion of SDOH Proposals in President’s FY24 Budget Request

On Thursday, March 9, President Biden released his Fiscal Year 2024 (FY24) budget request. The budget proposes $144.3 billion in discretionary and $1.7 trillion in mandatory budget authority for the Department of Health and Human Services for FY 2024.

The budget demonstrates the Administration’s commitment to areas such as health equity and maternal health, among other priority areas. According to HHS, “The budget also works to secure a healthier, more vibrant future for all Americans by investing in expanded coverage and access to care; addressing the needs of those most at risk, including Indian country, children, families, and seniors; growing our health workforce; and advancing science to improve health.”

Aligning for Health was pleased to see the inclusion of several key provisions related to SDOH, health equity, and maternal health in this budget request, including a $100 million request for the CDC for the Social Determinants of Health program. Through this particular request, CDC would continue to expand SDOH efforts by funding another round of Social Determinant Accelerator Plans to states, tribes, territories, and/or localities to develop new or implement and evaluate existing SDOH plans, including but not limited to, previously funded accelerator plans recipients, and building the evidence base through applied research, data collection, and surveillance.

For a full summary of the SDOH-related provisions included in the request, click here or see below:

AFH Summary - FY24 Presidents Budget Request - 3.10.23
2023-03-17T15:07:34+00:00March 17th, 2023|Press Release|

AFH Submits Comments on CMS RFI on Social Risk Factor Data

Aligning for Health submitted comments in response to the Request for Information regarding Accelerating the Adoption of Standards Related to Social Risk Factor Data within the recently proposed rule from CMS to advance interoperability and improve prior authorization processes. Through this RFI, CMS sought input on barriers to using industry standards and opportunities to accelerate the adoption of data collection standards related to social risk factor data, including exchange of information with community-based organizations.

Aligning for Health appreciates CMS’ continued efforts and commitment to ensuring providers and payers participating in federal health care programs can better understand and coordinate to address individuals’ health and social needs.

We applaud CMS and other federal partners’ focus on social risk factors and in identifying policies to address systemic drivers of health. We focus our comments on the importance of encouraging greater identification, documentation, and exchange of social risk and social needs data by removing barriers and by providing education and incentives for providers and payers. Beyond this, we encourage CMS to also expand incentives and ensure supports are in place for entities to provide access to and make referrals to available resources and to address identified social needs, as appropriate.

To read our comments, click here or see below:

Aligning for Health - CMS RFI on Social Risk Factors - 3.13.23
2023-03-14T20:08:06+00:00March 14th, 2023|Press Release|

Aligning for Health Applauds Key SDOH Provisions Included in FY2023 Omnibus Appropriations

On December 20, 2022, House and Senate Appropriators released the text of the FY2023 Omnibus Appropriations bill, which includes $1.7 trillion in appropriations for fiscal year 2023 and several key health care extenders and new authorizations. The Consolidated Appropriations Act, 2023 was signed into law by President Biden on on December 29, 2022.

Aligning for Health was thrilled to see the inclusion of many key social determinants of health policies, funding, and initiatives included in this package. Along with the appropriations bill, the accompanying Joint Explanatory Statement, which cross-references the House Committee on Appropriations Report for the Departments of Labor, Health and Human Services, and Education, and Related Agencies for Fiscal Year 2023 Appropriations, includes additional details related to the appropriated amounts.

Most notably:

  • CDC’s Social Determinants of Health Accelerator Grants continue to be funded at $8M for FY23.
  • Section 2201, Addressing Factors Related to Improving Health Outcomes, stems from the Senate HELP Committee’s PREVENT Pandemics Act and includes similar concepts as the Aligning for Health-endorsed Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act and the Social Determinants Accelerator Act. Aligning for Health has provided feedback on previous versions of this provision and looks forward to working with the Administration on its implementation.
    • Section 2201 authorizes the HHS Secretary to award $35M a year in grants, contracts, or cooperative agreements to states or other eligible entities to support the implementation of strategies to address factors related to health outcomes; to establish, maintain or improve technology platforms or networks to support coordination and information sharing; implementation of best practices; and supporting consideration of factors related to health outcomes in preparing for and responding to public health emergencies.

Other notable provisions include:

  • CMS – Social Determinants of Health. —The Committee encourages CMS to continue to clarify and disseminate strategies that States can implement under current Medicaid and CHIP authority, or through waivers, to address social determinants of health (SDOH) in the provision of health care, including strategies specifically targeting the pediatric population. This should include guidance on how States can encourage and incentivize managed care organizations to address SDOH through contracts.
  • CMS – Utilization of Z Codes for Social Determinants of Health. — The Committee is concerned about whether the current Z codes definitions are expansive and specific enough to track the SDOH impacting underserved communities. To help reduce these barriers, the Committee encourages HHS to update the current Z code definitions and establish a national standard to review SDOH to ensure physicians nationwide use the same tools to analyze SDOH. The Committee requests a briefing within 180 days of the date of enactment of this Act on the current utilization of Z codes, how HHS suggests the Z codes definitions could be updated to better track SDOH impacting underserved communities and recommendations on how to increase the utilization of Z codes.
  • CMS – Social Determinants of Health Analytics. —. The Committee requests a report within 180 days of the date of enactment of this Act on efforts by CMS to ensure the transparency by MA and MCO plans in the use of data of beneficiaries in addressing SDOH, how CMS ensures that MA and MCO plans notify beneficiaries of the use of protected or consumer data, and how ongoing CMS work with MA and MCOs around SDOH and the use of consumer data and protected medical information aligns with and improves health equity as per the goals of Executive Order 13985 and the HHS’s Equity Action Plan.

Below we have pulled notable provisions related to social determinants of health, health equity, and maternal health that were included as part of this package. You can also find this summary here.

AFH - SDOH in FY2023 Omnibus Appropriations Package - 12.20.22
2023-01-06T03:39:18+00:00December 21st, 2022|Press Release|

Aligning for Health Comments on CMS Make Your Voice Heard RFI

Aligning for Health submitted comments in response to the CMS “Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs” Request for Information (RFI).

Through this RFI, CMS is seeking to better understand individual and community-level burdens, health-related social needs, and opportunities for improvement that can reduce disparities and promote efficiency and innovation across our programs. CMS requested information related to strategies that successfully address drivers of health inequities, including opportunities to address social determinants of health and challenges underserved communities face in accessing comprehensive, quality care.

Aligning for Health supports many of the steps that the Biden-Harris Administration has taken to prioritize equity for all, including through initiatives to address social determinants of health. Our comments focused on questions posed in the RFI as it pertains to opportunities to better understand and address health-related social needs and to embed health equity into all CMS efforts, to include:

  • The need for coordination across sectors to reduce siloes and and better coordinate health care and social services;
  • Identifying and addressing social needs and disparities through improved data collection and standardization, screening for social needs, and assessment for if health-related social needs are being met;
  • Addressing data sharing within federal health programs and ensuring community-based organizations have the capacity to assist with connecting individuals to resources to meet their needs; and other areas.

To read our comments, click here or see below:

AFH - CMS Make Your Voice Heard RFI - FINAL
2023-03-08T19:52:33+00:00November 7th, 2022|Press Release|

AFH Holds Briefing on Coordinating Funding & Data to Address SDOH

On September 29, 2022, Aligning for Health held a briefing highlighting programs and best practices on coordinating funding and data to address social determinants of health, featuring perspectives and examples from the federal government, state and local leaders, and their partners.

Addressing social determinants of health requires coordinating services, benefits, and care across both the health care and social services sectors. Often, the funding and administration of each of these programs is siloed, with minimal flexibility to leverage health care funding to pay for social needs, or to share data across programs on eligibility, enrollment, or utilization of services. Organizations across the country have long worked to close these gaps and find ways to coordinate across sectors, and recently there has been growing interest in aligning incentives and providing more flexibility and opportunities for programs to collaborate.

Speakers: 
  • Dr. Sandra Ford, Special Assistant to the President for Public Health and Science at the White House
  • Erica Coletti, CEO, Healthy Alliance
  • Sue Polis, Director, Health & Wellness, National League of Cities
  • Amy Riegel, Executive Director, Coalition on Homelessness & Housing in Ohio (COHHIO)
  • Krista Drobac, Co-Chair, Aligning for Health (moderator)
Recorded on September 29, 2022

2022-10-03T17:16:22+00:00October 3rd, 2022|Press, Press Release|

Aligning for Health Submits Comments to CMS RFI on Medicare Advantage

On August 31, Aligning for Health submitted comments in response to the CMS request for information (RFI) on the Medicare Advantage program.

Aligning for Health supports many of the steps that the Biden-Harris Administration has taken to prioritize equity for all, including through initiatives to address social determinants of health (SDOH). In our response, we provide comments to the specific questions posed in the RFI as it pertains to opportunities to address social determinants of health to advance health equity within the Medicare Advantage program.

To view the full letter, click here or see below:

Aligning for Health - CMS RFI on Medicare Advantage - FINAL
2023-03-08T19:53:00+00:00September 1st, 2022|Press Release|

Key SDOH Inclusions in FY2023 Senate Appropriations Report

On July 28, 2022, the Senate Committee on Appropriations released the Report for the Departments of Labor, Health and Human Services, and Related Agencies for Fiscal Year 2023 Appropriations. The report includes specific instructions with respect to the appropriated amounts. The House previously released its Report for the Departments of Labor, HHS, Education, and Related Agencies for FY2023 on June 29, 2022. Final text merging the House and Senate appropriations provisions will be available later this year. For reference, a list of the notable SDOH provisions included in the House report language can be found here.

Aligning for Health was thrilled to see the many inclusions to support forward movement in addressing social determinants of health, health equity, and maternal health. Notable language in the report includes:

  • CDC – Social Determinants of Health [SDOH]. — The Committee provides $100,000,000 to expand SDOH activities to all States and territories. These activities should include expanding and implementing accelerator plans and providing grants for implementation of SDOH activities. CDC should award grants to improve the capacity of governmental and non-governmental public health organizations and community organizations to address SDOH in communities; support and conduct research on best practices; and improve health outcomes and reduce health inequities by coordinating SDOH activities across CDC. The Committee urges CDC to fund and integrate knowledge from behavioral science research as part of the effort to develop new evidence-based interventions to ameliorate social determinants’ potential negative effects. The Committee believes that behavioral science research focused on understanding SDOH can increase the use of and adherence to healthy behaviors that help prevent chronic conditions such as cancer, heart disease, and diabetes.
  • CDC – Racial and Ethnic Approaches to Community Health [REACH]. — The Committee includes an increase of $10,000,000 to continue scaling this program to all States and territories, and to support grantees in building capacity for collaboration and disseminating evidence-based strategies in communities. REACH is a vital initiative to help eliminate healthcare disparities in minority communities. The Committee’s recommended level includes an increase of $4,000,000 for Good Health and Wellness in Indian Country.
  • CDC – National Center for Health Statistics. —The Committee provides an increase of $10,000,000 for CDC to expand the sample size for the National Health Interview Survey. The Committee intends for this increase to be used to support intersectional analyses of healthcare access, chronic health conditions, including long-COVID, and mental health status by race, ethnicity, sexual orientation, and gender identity. The collection of this disaggregated data should also support the Administration’s initiative to advance equity and racial justice for Asian Americans, Native Hawaiians, and Pacific Islanders and other underserved communities.
  • Office of Minority Health – Achieving Equitable Maternal Health Outcomes. —The Committee recommendation provides $7,000,000 for awards to community-based and other eligible organizations located in geographic areas with high rates of adverse maternal health outcomes, particularly among racial/ethnic minority families. The awards will support activities that include but are not limited to identifying evidence-based and evidence-informed practices for: addressing social determinants of health; promoting evidence-based health literacy, and pregnancy, childbirth, and parenting education programs; providing support from perinatal health workers; and providing culturally congruent, linguistically appropriate, and trauma-informed training to perinatal health workers.
  • HHS Office of the Secretary – Population Health Data Modernization. —The Committee notes that many healthcare providers that treat uninsured patients and Medicaid beneficiaries often lack population health management tools and modernized information technology systems to support comprehensive care for these individuals. To mitigate the risk of increasing disparities and inequity in the care for these patients, the Secretary is encouraged to develop-in coordination with ONC, HRSA and CMS-a roadmap for modernizing the technology systems used by healthcare providers that disproportionately treat underserved populations.
  • SAMHSA – Projects for Assistance in Transition from Homelessness [PATH]. – The Committee recommends $69,635,000 for PATH, which addresses the needs of individuals with serious mental illness who are experiencing homelessness or are at risk of homelessness.
  • HRSA – Community Health Centers. – The Committee provides $1,918,772,000, an increase of $170,000,000 above the fiscal year 2022 enacted level. Programs supported by this funding include community health centers, migrant health centers, healthcare for the homeless, school-based, and public housing health service grants. In addition, within the amount provided, the Committee provides up to $120,000,000 under the Federal Tort Claims Act [FTCA] (Public Law 102–501 and Public Law 104–73), available until expended.
  • HRSA – Maternity Care Target Areas [MCTAs]. —The Committee includes $5,000,000, an increase of $4,000,000 above the fiscal year 2022 enacted level, within the Corps to implement requirements contained in the Improving Access to Maternity Care Act, including establishing criteria for and identifying MCTAs and collecting and publishing data on the availability and need for maternity care health services in health professional shortage areas.

Below, we have pulled notable report language related to social determinants of health, health equity, and maternal health that were included as part of this report for the HHS Office of the Secretary, Assistant Secretary for Health, CMS, CDC, SAMHSA, HRSA, and HHS Office of Minority Health (OMH).

AFH - FY23 Senate Appropriations Report Summary - 28 July 2022
2022-08-04T19:24:45+00:00August 4th, 2022|Press, Press Release|
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