Fly-in: Social Determinants of Health

You will need to be escorted to the meeting room, look for the Health Plan Alliance sign in the lobby

Providers and payers are forging new, innovative programs and relationships, in part driven by the CMS commitment to move into value-based reimbursement and two-way risk. This group discussion will focus on the current state of these collaborative efforts and what is possible in the future.

Pilots who point the aircraft’s nose directly into a headwind during takeoff will get much greater lift – they effectively climb the wind to get to the desired cruising altitude much sooner, which requires less runway and is better for the plane’s equipment. By facing social determinants of health with the same calculated bravery, healthcare organizations can also leverage the opportunity to achieve desired outcomes more quickly. And by embedding this approach into systems, workflows, and payment, we can sustainably climb the wind again and again with less stress to our infrastructure. In this session Brendan O’Connor of Solera reflects on his years helping healthcare organizations meaningfully incorporate SDOH into their member care strategies. He describes the learning curve payers and providers experience as they learn to navigate headwinds successfully. This session addresses the foundational requirements for health plans and providers to meaningfully address the social needs of members:

Know your true north: what are the organization’s objectives of addressing the social needs of its members? Alignment between the organization-wide and SDoH strategies is critical to avoid distractions and move in a straight line despite hurdles that will be encountered.

Understand the need: organizations too often make decisions lacking the data required to best inform those decisions. How can healthcare move beyond claims, layering on health risk assessment data, community health needs assessments, community health worker data, standardized SDoH screening tools, and other data to more accurately predict risk, understand need, and make more informed decisions?

Be an effective matchmaker: once the needs are well understood, now what? Your CHWs, case managers, and social workers can become more effective matchmakers with the right tools. Resource directories are moving into the 21st century, but is it enough to be a connector? What data will your partners need? What data do you expect to be fed back into your systems? Do the partners have capacity to serve additional members with current resources?

Leverage data to inform action: Leveraging your improved data from effective screening and community resource connections, you should now be able to more accurately understand need and predict risk, all the way down to the city block or individual level.What would you do with this powerful knowledge?

Now…act!: The infrastructure described above should enable a more confident and quick transition from pilot to scale. With the right strategy and foundational infrastructure, we can create a thriving ecosystem of digital and community partners supporting your members.

Breakfast

Alliance Offices (2^nd floor, Conf Rm 2505 & 2506)

8:00 – 8:30am

Welcome Back!

Recap of yesterday’s discussion, attendee introductions, looking ahead to today’s agenda, and sponsor acknowledgments.

• Relevant recent research findings

• Policy updates: SDOH in Medicare Advantage and Medicaid

• Industry moves, e.g., Kaiser/United investments, transactions in the space

• What housing integration looks like when insurers and providers get into it

• What to expect in SDOH benefits in the next 3 years

• Innovative financing vehicles: social impact bonds and Opportunity Zones

Lt. Governor Josh Green estimates that he spends 70 percent of his time focused on finding big and small ways to get more homeless people off the street. In his role, Lt. Governor Green connects public and private sector stakeholders, and is at the forefront of multiple projects designed to positively impact the homeless crisis in Hawaii. He shares the science and art needed to fully define the problem, design solutions that are both effective and sustainable, and to bring multiple stakeholders together in service of these vulnerable populations.

Hear examples of housing programs implemented to address SDOH, including funding, early and predicted results, and plans for future expansion. You will learn how payers and provider organizations can collaborate with community and non-profit organizations to achieve better patient care and outcomes.

The negative health impacts of homelessness and housing needs contribute to major health issues, premature death, and drive up cost for the healthcare system. The exact role and responsibility of healthcare organizations in addressing these factors is not always clear and deserves consideration.

In this session, Spring Street Exchange will use a visioning scenario framework to translate ideas into practical application. We will envision what is possible, what is best for the people involved and what is right for healthcare.