Q&A: Using nonclinical resources to address health disparities
Q: How are nonclinical resources being used by Medicare to improve health outcomes and access to care under Medicare Advantage?
A: Increasing focus is on recent action by CMS to address socioeconomic status and the social determinants of health (SDoH) for beneficiaries of the Medicare Advantage program. Using the premise that the SDoH drive poor health outcomes and increase costs, it has become a must for CMS to equalize these factors by providing related coverage to beneficiaries.
The provision of and linkage to nonclinical resources is a proactive approach to the care and treatment of healthcare populations. The action has tremendous opportunity to decrease healthcare spending through providing items such as:
- Air conditioners for those with asthma or emphysema
- Nonemergent medical transportation to reduce obstacles to care access
- Healthy foods for those struggling with diabetes and renal disease
CMS has expanded the definition of “primarily health-related” to allow for supplemental benefits that account for physical illness and impairments and decrease the impact of injuries or health conditions on health and wellness. It is expected that this benefit expansion will also reduce avoidable emergency room utilization, if not also hospitalization.
For more information, see the HCPro book, The Social Determinants of Health: Case Management's Next Frontier.
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