Adjusting Medicare payments for social risk to better support social needs

Social determinants of health have greater influence on health than does health care, yet Medicare and most other payers have yet to adjust payments to better support the capacity of health care providers to address social needs. The 2014 Improving Medicare Post-Acute Care Transformation (IMPACT) Act directed the secretary of Health and Human Services (HHS) to review evidence linking social risk with performance under existing federal payment systems and to suggest policy options. In response, HHS produced two reports and commissioned a series of five additional reports from the National Academies of Sciences, Engineering, and Medicine (NASEM). The second HHS report suggests that area-based (or, geographically based) measures of social deprivation could play a role in payment adjustment.