There is a significant body of academic work showing that economic and social conditions have a powerful impact on individual and population health outcomes as well as health care costs. These non-clinical factors – such as housing, food assistance, income, employment status, education and transportation – have the potential to contribute to health outcomes more than clinical health care. In fact, one widely cited study found that while 10 percent of premature deaths in the U.S. are due to clinical health care, social and environmental factors are estimated to account for 60 percent of health outcomes.
Recognizing this link, governors, public health officials and Medicaid directors throughout the country have engaged in efforts to address the ever-increasing cost of health care by integrating more social determinants of health into their approach to Medicaid. While there have been successes, many states and local governments have experienced challenges in embarking on and implementing cross-agency, cross-program coordination. Many who run state programs agree that the greatest challenge to realizing innovative, high-impact approaches to social determinants is the difficulty in wading through the fragmented and complex nature of federal and state funding and administrative requirements.
Through a combination of research and data collection, direct advocacy, coalition building, and media outreach, Aligning for Health is energizing stakeholders and policymakers around the need for targeted technical assistance and funding to states and communities to help them design high-impact, cross-system strategies that achieve better health outcomes for Medicaid beneficiaries, improve program effectiveness, and lower healthcare costs.
Krista Drobac, MPP | Chair
Krista Drobac is the Chair of Aligning for Health, an advocacy coalition is a collective voice to advance innovative strategies that address the social determinants of health through legislation, regulation, and public awareness. AFH brings together a team of federal and state experts to address the issues that challenge the common purpose of our members – the need for integrated and coordinated cross-sector programs to improve health outcomes for Americans. Krista previously directed the Health Division at the National Governors Association’s Center for Best Practices. Prior to NGA, she was a Senior Advisor at the Center for Medicare & Medicaid Services (CMS) working in Medicaid and private insurance regulation. She also served as Deputy Director of the Illinois Department of Healthcare and Family Services and spent five years on Capitol Hill where she was a health advisor to the Minority Whip Senator Dick Durbin, and Senator Debbie Stabenow, a member of the Senate Finance Committee. Krista holds a BA from the University of Michigan and an MPP from the Harvard University Kennedy School of Government.
Ashley Gray, MPP | Executive Director
Prior to joining Aligning for Health, Ashley served as a Project Lead at MITRE where she led a large contract and team that provided support to the Data and Systems Group in the Centers for Medicaid and CHIP Services (CMCS) in administering and overseeing funding for state Medicaid Enterprise Systems, Health Information Exchanges, and systems used by human services agencies. She previously led federal and state Medicaid policy at Blue Cross Blue Shield Association (BCBSA) and Medicaid Health Plans of America (MHPA) and performed grant-funded research on key issues including social determinants of health, disparities, maternal child health, substance use disorder, and childhood obesity.
Ashley earned her BA in Public Policy, English, and Philosophy from Vanderbilt University and MPP, with a concentration in health policy, from the Thomas Jefferson Program for Public Policy at the College of William and Mary.
Ashila Jiwani, MS, MBA
Ashila has experience in the non-profit space, leading advocacy strategies focused on legislation to advance health care and equity, such as social determinants of health, maternal mortality, and increasing access to health care for immigrant families. She previously was the Clinical Director for MobileVAX, consulting Community Organized Relief (CORE) Response on best standards, processes, and practices for the COVID-19 vaccination efforts in the state of Georgia. She also piloted the Georgia mobile vaccination clinics for the South-Central Georgia public health districts. Additionally, she has vast experience in grassroots organizing with federal elections.
Ashila earned her Master of Science from Georgetown University, her Master in Business Administration from Mercer University, and her Bachelor of Arts from Mercer University. She is trained in political communications strategy by Arena Academy and is also trained as a registered nurse.
Aligning for Health
Aligning for Health is a membership association which, with the support of our members and Advisory Board, advocates for solutions that address the common challenge of our members – the need for more integrated and coordinated programs to better improve health outcomes for Americans.
The AFH team:
- Assesses current opportunities for coordination of relevant health and human service programs across the federal government, such as housing, food assistance, workforce training, transportation and Medicaid.
- Identifies successful state- and locally-developed cross-sector models addressing social determinants, and reviewed the role of the private sector and charitable initiatives in such models.
- Meets with county and state officials to understand the challenges and barriers they face in addressing the whole-person needs of vulnerable and/or or high-cost patients.
- Build and execute on an advocacy campaign to support solutions to address social determinants.
- Cultivates supportive Governors and state and local officials.
- Lobbies the Biden Administration and Congress.
- Educates interested stakeholders.
- Works with agencies at the state and federal level to assist in developing Social Determinants Accelerator Plans.
Advisory Board Members:
- Nicole Barcliff, Local Initiatives Support Corporation (LISC)
- Matthew Chase, National Association of Counties (NACo)
- Jason Gromley, Share Our Strength
- Jason Helgerson, Helgerson Solutions Group and Former New York Medicaid Director
- Matthew Lyons, American Public Human Services Association (APHSA)
- Marcella Maguire, Corporation for Supportive Housing
- Jerold Mande, Harvard University, Adjunct Professor of Nutrition, Senior Advisor to the President at the Center for Science in the Public Interest, former Senior Advisor on Food/Nutrition, USDA
- John McCarthy, Speire Healthcare Strategies, Former Medicaid Director in Ohio and the District of Columbia
- Len M. Nichols, PhD, Non-Resident Fellow, Urban Institute and Professor Emeritus, George Mason University
- Jill Rosenthal, Center for American Progress (CAP)
- Andrew Sperling, National Alliance for Mental Illness (NAMI)
- Kathy Stack, KB Stack Consulting, Former OMB Official
- Karin VanZant, Clearlink Partners
- Rick Whitted, U.S. Hunger
- Sandra Wilkniss, National Academy for State Health Policy (NASHP)
- Ginger Zielinskie, Data.org