I want to commend Modern Healthcare for the recent series looking at how Cleveland health systems are attempting to address the social determinants of health.
It’s a remarkable turn of events in just a few short years. Ten years ago I served as Ohio’s Medicaid director and I can assure you that Cleveland hospitals weren’t talking to me then about social determinants of health or about what was transpiring outside the walls of their hospitals. They were more concerned with raising reimbursement rates than with whether their patients had a place to live, food to eat, or access to a good job or education.
That began to change with the passage of the Affordable Care Act and the expansion of Medicaid in Ohio. Hospitals and systems like MetroHealth, which previously struggled with tens of millions of dollars in uncompensated care, suddenly saw that unpaid care plummet and were able to shift attention toward hospital transformation, but even more importantly was a new focus on community transformation.
It’s these latter efforts, whether through high schools, employment programs, affordable housing development, or a food pharmacy, that may hold the most promise for improving health and long-term transformation. Moving forward it will be important to evaluate these programs and to share results broadly so that what is working Cleveland can be replicated across the country. It’s good to know you are among those watching.
President and executive director
Center for Community Solutions