The National Quality Forum has offered a framework for Medicaid programs to better measure and address the social risks of their patients.
In a report released Thursday, the NQF called on state Medicaid programs to work more with healthcare organizations and communities to better manage social disparities.
The report "talks about the need for collaboration with healthcare community stakeholders—really it's a call for them to collaborate more beyond what they are currently doing," said Andrew Anderson, senior director at NQF and the lead on the report.
The report comes just a few months after CMS decided it will allow states to impose work requirements for its Medicaid enrollees. Critics—many of which are healthcare providers—argue the requirement will only exacerbate these patients' social risks because it will likely cause some to lose their insurance status. Medicaid enrollees in Kentucky are challenging that state's recently approved waiver in court, arguing that it will ultimately result in beneficiaries being kicked out of the program.
The NQF report noted that Medicaid programs are "uniquely suited" to lead the charge on addressing social determinants of health because they serve more than 74 million beneficiaries across the U.S., many of whom would benefit from services like housing, nutrition and transportation. Many Medicaid programs are already working on addressing social needs through 1115 waivers.
NQF outlined several strategies to integrate social risk into clinical care.
The NQF recommended that Medicaid programs and other healthcare providers compile and routinely update comprehensive lists of local community services.
An example of this is the Oregon Food Bank, which maintains a list of the food and nutrition education resources available in every Oregon county in 13 languages. The list is used at 300 organizations across the state, the report said.
Another strategy is for Medicaid programs to collaborate with commercial health plans to standardize the tools used to assess social determinants of health. This will allow different healthcare organizations to compare data and reduce administrative burden.
More work also needs to be done to share data between government agencies, healthcare providers and community organizations, the NQF said. For example, a provider could benefit from knowing if their patient is enrolled in the federal Supplemental Nutrition Assistance Program.
Some Medicaid programs have started to coordinate with social service programs to share data, the report noted, but there are more opportunities to work together.
The NQF presented the report prior to its release to the National Association of Medicaid Directors to get their feedback.
"The committee on this project was trying to push the field a little further by coming up with what we need to do in the next phase while still leveraging what we are already doing," Anderson said.
