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Azar: CMMI Will Get More Involved in Addressing Social Needs Driving Health Issues


HHS Secretary Alex Azar plans to ensure his agency handles both the health and the human services, as stated in its name, of Americans. In a recent speech, he hinted that the Center for Medicare and Medicaid Innovation will be doing more work in areas adjacent to healthcare, such as food insecurity, and housing, utility, and transportation needs.

In recent years, the government has turned its attention to addressing social determinants of health as a way to reduce costs and keep patients healthy. During a speech at the Hatch Foundation for Civility and Solutions, HHS Secretary Alex Azar outlined how his agency is planning to get more involved with addressing social needs that impact patients’ health.

He noted that by its very name, his agency covers not just health, but also human services, which means HHS is set up to think about all the needs of vulnerable Americans.

And while the federal government will continue to take the lead on financing healthcare, “we believe we could spend less money on healthcare—and, more important, help Americans live healthier lives—if we did a better job of aligning federal health investments with our investments in nonhealthcare needs,” Azar said in his prepared remarks.

The administration is considering how to improve healthcare and social services with a decentralized, flexible approach. This will allow areas to focus on the services that make the most sense. For instance, common needs across the country may be nutrition and housing, but in rural areas transportation may be the real challenge, he said.

“Just like how every patient is different in healthcare, every person has unique social service needs—and we are intent on designing models that connect them to the services they need, rather than offering a one-size-fits-all approach,” Azar said.

He pointed to the Accountable Health Communities model from the Center from Medicare and Medicaid Innovation (CMMI), which was announced in 2016 and launched last year. The model incentivizes providers to screen high utilizers for social needs, such as food insecurity or transportation, housing, and utility needs. If the screening identifies a patient has a social need that impacts his or her health, the provider sets the patient up with a navigator who can identify relevant resources in the community that will help meet the patient’s needs.

“But what if we went beyond connections and referrals? What if we provided solutions for the whole person, including addressing housing, nutrition, and other social needs?” Azar asked. He provided examples such as paying a beneficiary’s rent or ensuring a patient with diabetes could afford healthy food. “If that sounds like an exciting idea…I want you to stay tuned to what CMMI is up to.”

Mavis Asiedu-Frimpong, director for national initiatives at the Camden Coalition of Healthcare Providers, which is committed to elevating the health of patients facing the most complex medical and social challenges, called the news tremendous. In an interview with The American Journal of Managed Care®, Asiedu-Frimpong explained that integrated and coordinated systems of care are needed to provide care for patients with overlapping medical, behavioral health, and social needs, many of whom are served by the Medicaid program, but that funding is often an issue.

“Having the Medicaid program really value social determinants of health, and really value the idea that health is not just about healthcare—it’s about the conditions in which we live and work—I think it’s a critical step forward for the administration and a critical step forward for the field, as well,” Asiedu-Frimpong said.

The vision to address social determinants of health does not end with Medicaid and vulnerable populations—Azar also mentioned the Medicare program and providing Medicare Advantage plans the flexibility to address these issues with older patients, as well.

By 2020, the government will expand what plans can pay for to include things like home modifications and home-delivered meals, Azar said.

“These interventions can keep seniors out of the hospital, which we are increasingly realizing is not just a cost-saver, but actually an important way to protect their health, too,” he said.

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