It’s a busy time in the social determinants of health (SDoH) space with increasing emphasis on integrated, if not whole person, care. Organizations are finally getting the mantra, “there’s no health without mental health,” and that certainly applies to society’s vulnerable and marginalized populations. An increased focus surrounding funding, programming, and other resources are rapidly emerging to ensure outcomes reflect the highest quality available for patients.
Here’s a snapshot of what’s on the wholistic health horizon for patients and families across population health:
- The WHO guide for integration of perinatal mental health: The guide offers guidance for program managers, administrators, and policy-makers to develop high quality integrated mental health services for women during the perinatal period. Sample templates, budgets, and evaluation indicators are provided.
- Mandatory anxiety screening for adults under 65: The dramatic uptick in behavioral health issues for all ages has prompted a novel recommendation from the U.S. Preventative Services Task Force for routine anxiety screening for all adults under the age of 65, independent of symptom presentation. The incidence of anxiety has traditionally ranged from 30-35 percent of the population. These numbers have risen drastically amid the pandemic, by well-over 25 percent, though less than 50 percent of the population receives treatment. Persons at risk of SDoH are increasingly vulnerable. Use of established screening tools (e.g., DASS-21, GAD-7) are recommended.
- Mental health pay parity and the new HHS roadmap: Over 90 percent of the population has experienced a mental health crisis in recent years with growing emphasis on providing mental health intervention to those in need. In efforts to advance the “strengthen system capacity” of the President’s National Strategy, emphasis is on increasing mental health provision within primary care settings. Studies have already shown this programming is especially effective within safety-net programs (e.g., hospitals, federally qualified health centers (FQHCs), rural and community health clinics); they already present with a higher incidence of behavioral health issues, upwards of 80 percent of patients.
- Expansion of integrated team programs by Cityblock Health: The successful primary care model forged by Cityblock Health is expanding into Indiana to deliver medical care, behavioral health, and social services to historically underserved communities, including persons with complex care needs. The company has a strong presence in five other states, including Connecticut, Massachusetts, New York, North Carolina, Ohio, as well as the District of Columbia.
- California’s Advancing and Innovating Medi-Cal (CalAIM) initiative: California has among the largest Medicaid populations across the states, over 13 million persons. The Whole Person Care program under the state’s 1115 wavier has been successful and is now advancing across assorted other state pilots with the following goals:
- Identification and management of member risk and need via whole person care approaches that address SDoH
- Improvement of quality outcomes, reduction of health disparities, and driving delivery system transformation and innovation through value-based initiatives, modernization of systems, and payment reform
- Movement of Medi-Cal to a more consistent and seamless system by reducing complexity and increasing flexibility
- Rethinking rural health and integrated care access: Health and mental health deserts are expanding across rural regions on the United States, and hospitals continue closures at record rates with access to care obstructed. Even the new 988 hotline isn’t sufficient enough to mitigate profound gaps in care, including lack of crisis teams or mental health resources. Broadband and WiFi access continue to hamper use of telehealth. CMS continues to support the “rethinking rural health” program that strives to promote access to the wholistic health triad of physical, behavioral, and psychosocial health.
More innovation is on the horizon as organizations recognize the clinical and fiscal value of whole person care. To join the conversation around SDoH policy, join us at RISE’s inaugural event, The Social Determinants of Health Policy Forum, hosted in partnership with Aligning for Health, a member association that advocates to Congress for solutions to address SDoH, on November 28-30 in Washington, D.C.