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Addressing social factors in the health care safety net

L. Smith, P. Sion, A. Stevenson, P. Kasen, N. Harstad
California Health Care Foundation

Spurred on by reforms included in the Affordable Care Act and other national trends, California is fundamentally transforming how it pays for the care of patients in Medi-Cal, its state Medicaid program. Rather than maximizing the volume of care delivered, regardless of outcome, Medi-Cal payers and providers must now optimize value, which couples improved health with manageable costs.

Driven by this shift, health plans and delivery systems are paying greater attention than ever to the factors beyond health care — like community, safety, education, and family stability — that influence a person’s health. If health outcomes are to improve, Medi-Cal providers and health plans must to be able to understand the comprehensive needs and circumstances of their patients, and learn to coordinate with complex support systems to make sure those needs are met.

The safety net is an ideal market for innovative, collaborative solutions that empower providers to understand their patients’ medical and social needs. Given their growing understanding of the cost-effectiveness of prevention and their drive to contain costs, commercial markets may soon seek such solutions, too.

Smith L, Sion, P, Stevenson A, Kasen P, Harstad N. Primed: Addressing Social Factors in the Health Care Safety Net. California Health Care Foundation; 2017. Available online.

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