Social determinants of health and Medicaid payments

Greater use of the emergency room has been linked to homelessness, diabetes-related hospital admissions have been attributed to food insecurity, and social isolation has been identified as a risk factor for stroke and heart attack. These are just a few of the ways in which the social determinants of health (SDoH) contribute to health outcomes, health care utilization, and spending. These determinants, which include social, economic, and environmental factors such as income, housing, transportation, and education, account for roughly 20 percent of premature deaths in the United States.

Increased awareness of how SDoH can affect health outcomes has prompted many practitioners and policymakers to rethink health care delivery—especially for Medicaid beneficiaries, whose low incomes typically make them disproportionately likely to have health-related social needs. In fact, there are a number of broad-scale efforts now under way to identify and direct resources toward individuals with social needs. For example, some states are beginning to require managed care organizations (MCOs) to screen enrollees for social needs. Meanwhile, some providers and plans around the country are working with community-based organizations (CBOs) to link individuals to resources such as food pantries, housing supports, and transportation assistance.

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