Robert Wood Johnson Foundation Advances Guidance to Address SDoH

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Original story posted on: March 17, 2021

The iconic foundation has published three Federal Policy Recommendations to Advance Health Equity.

First, I’d like to follow up on last week’s article about The Gravity Project’s presentation on social risk ICD-10-CM code changes at the March 10 Centers for Disease Control and Prevention (CDC) National Center of Health Statistics Coordination and Maintenance Committee meeting. While we wait, industry advocacy is critical. The current timetable has approved changes scheduled for release on Oct. 1, 2022. If you want this timeframe moved up, email comments to nchsicd10CM@cdc.gov by April 9. 

In the meantime, formal recommendations to directly address the social determinants of health (SDoH) continue. The Robert Wood Johnson Foundation has published three Federal Policy Recommendations to Advance Health Equity briefs. Each brief offers recommendations to solve structural problems that impede equitable, stable, and affordable access to food, housing, and health insurance.

Brief 1, Improving Housing Affordability and Stability, focuses on:

  • Strengthening the CDC's eviction moratorium to ensure the availability of housing during the COVID-19 crisis, including an ongoing moratorium on utility shutoffs and providing funding assistance to landlords;
  • Reversing housing regulations like those meant to penalize people's citizenship status based on their use of social supports; 
  • Restructuring programs such as low-income housing tax credit programs; 
  • Helping low-income renters; and 
  • Revamping public housing.

Close to 18 million households spend half or more of their income on housing.

Brief 2, Increasing Access to the Supplemental Nutrition Assistance Program (SNAP), requests:

  • Increasing SNAP benefits immediately and for the long term; 
  • Expanding availability of resources to support healthier food purchases;
  • Streamlining eligibility and enrollment processes; and
  • Eliminating regulations that would limit access to SNAP benefits.

A total of 7.8 million individuals fell into poverty between June and November 2020, with close to 12 percent of the U.S. population now living in poverty.

Brief 3, Increasing Access to Affordable and Comprehensive Health Insurance, offers recommendations to:

  • Increase Patient Protection and Affordable Care Act (PPACA) Marketplace enrollment and reverse policies that limit coverage in the Marketplace and Medicaid;
  • Incentivize states to expand Medicaid;
  • Increase Marketplace coverage affordability;
  • Close the Medicaid coverage gap; 
  • Reduce prescription costs;
  • Implement the “No Surprises Act" in a way that maximizes the cost containment potential (for those not aware, the Act goes into effect on Jan. 1, 2022, making it illegal for providers to bill patients for more than the in-network cost sharing due under patients’ insurance in almost all scenarios where surprise out-of-network bills arise, with the exception of ground ambulance transport); and
  • Improve opportunities for working people with disabilities to access Medicaid.

Reports published in late 2020 indicated close to 29 million uninsured persons across the country. However, these figures did not account for the 14 million or more persons left unemployed by the COVID-19 pandemic.

These three policy briefs provide important industry attention, especially for regulatory entities that define reimbursement. Hopefully the Centers for Medicare & Medicaid Services (CMS) and the Coordination and Maintenance Committee members are listening! Get those emails to nchsicd10CM@cdc.gov by April 9! The industry needs expanded SDoH reimbursement now.

Programming Note: Listen to Ellen Fink-Samnick’s live reporting on SDoH every Monday during Monitor Mondays at 10 a.m. Eastern.

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management,  Social Determinants of Health: Case Management’s Next Frontier (with Foreword by Dr. Ronald Hirsch), and End of Life Care for Case Management are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk-Ten-Tuesdays, and member of the Editorial Advisory Boards of Professional Case Management, Case Management Monthly, and RAC Monitor. Ellen also serves as the Lead for Rise Association’s Social Determinants of Health Community.

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