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As a result of a large and compelling body of evidence documenting the impacts of social determinants, such as income and
education, on health outcomes, health care systems are beginning to incorporate social and economic risk data into health
care delivery decisions. But there is a risk that some of these efforts could worsen health and widen health inequities. We
highlight 3 examples— including recent policy changes in Medicaid, social needs, informed risk prediction models, and advances
in precision medicine—where the inclusion of social risk information threatens to reduce care quality or health care access
for some groups of patients. A new dialog is needed about both the opportunities and potential consequences of bringing information
about patients’ social circumstances into a market-based health care system.
As a result of a large and compelling body of evidence documenting the impacts of social determinants, such as income and
education, on health outcomes, health care systems are beginning to incorporate social and economic risk data into health
care delivery decisions. But there is a risk that some of these efforts could worsen health and widen health inequities. We
highlight 3 examples— including recent policy changes in Medicaid, social needs, informed risk prediction models, and advances
in precision medicine—where the inclusion of social risk information threatens to reduce care quality or health care access
for some groups of patients. A new dialog is needed about both the opportunities and potential consequences of bringing information
about patients’ social circumstances into a market-based health care system.
BackgroundEmerging evidence indicates that patients with mental health conditions (MHCs) may receive less intensive medical care. Diabetes serves as a useful co
Conclusion
States can use the evidence base for care management to select diseases and interventions and to set appropriate expectations for program outcomes. The literature review identified a few important findings across diseases.
Care Management Success. Across all diseases, the literature found examples of successful care management programs in terms of intervention outcomes. Although the body of literature was significantly smaller for certain diseases and, therefore, less conclusive, successful interventions still can be identified.
Intervention Effectiveness. Although interventions ideally would prove equally effective for all diseases, the literature review found that they might vary among diseases in terms of their overall efficacy and, in particular, which outcomes they impact. For example, the literature review found that telephonic care management was more effective overall for asthma as compared with diabetes.
In-Person Care Management. In-person care management was the most effective intervention across all five diseases. Although it can be more difficult and expensive to implement, in-person care management is the best intervention to use to generate cost savings and improve clinical outcomes.
Provider Interventions. As expected, provider interventions exerted the greatest impact on measures that target provider processes such as HbA1c screening or medication use. States can employ provider interventions to impact process measures or, in some cases, utilization or cost, but overall provider interventions had minimal impacts on clinical outcomes.
The following disease-specific synopses outline the impact of multiple care management interventions. For more information on specific outcomes, please refer to the Review Synopses.
In-Person Care Management. In-person care management was the most effective intervention across all five diseases. Although it can be more difficult and expensive to implement, in-person care management is the best intervention to use to generate cost savings and improve clinical outcomes.
Provider Interventions. As expected, provider interventions exerted the greatest impact on measures that target provider processes such as HbA1c screening or medication use. States can employ provider interventions to impact process measures or, in some cases, utilization or cost, but overall provider interventions had minimal impacts on clinical outcomes.
Provider Interventions. As expected, provider interventions exerted the greatest impact on measures that target provider processes such as HbA1c screening or medication use. States can employ provider interventions to impact process measures or, in some cases, utilization or cost, but overall provider interventions had minimal impacts on clinical outcomes.
Provider Interventions. As expected, provider interventions exerted the greatest impact on measures that target provider processes such as HbA1c screening or medication use. States can employ provider interventions to impact process measures or, in some cases, utilization or cost, but overall provider interventions had minimal impacts on clinical outcomes.
The Kaiser Family Foundation website provides in-depth information on key health policy issues including Medicaid, Medicare, health reform, global health, HIV/AIDS, health insurance, the uninsured and much more.
The Kaiser Family Foundation website provides in-depth information on key health policy issues including Medicaid, Medicare, health reform, global health, HIV/AIDS, health insurance, the uninsured and much more.
Medicaid and the Children’s Health Insurance Program (CHIP) provide health and long-term care coverage to more than 70 million low-income children, pregnant women, adults, seniors, and people with disabilities in the United States. Medicaid is a major source of funding for hospitals, community health centers, physicians, and nursing homes. States operate their Medicaid programs within federal standards and a wide range of state options in exchange for federal matching funds. The two-page fact sheets provide a snapshot with key data for Medicaid in every state related to current coverage, access, and spending.
Health and health care disparities refer to differences in health and health care between population groups. Disparities occur across many dimensions, including race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation.
Health and health care disparities refer to differences in health and health care between population groups. Disparities occur across many dimensions, including race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation.
Health and health care disparities refer to differences in health and health care between population groups. Disparities occur across many dimensions, including race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation.
NCHHSTP's Social Determinants site has moved to www.cdc.gov/nchhstp/SocialDeterminants. You are about to be re-directed.
At a time when we are trying to understand how ZIP codes influence our quality of life, rural people share lessons about what it takes to build equity and opportunity in their communities.
At a time when we are trying to understand how ZIP codes influence our quality of life, rural people share lessons about what it takes to build equity and opportunity in their communities.
Long before we need medical care, our foundation for health begins in our homes, schools, jobs and neighborhoods. Learn how RWJF is working to address the social and economic factors that most affect health where we live, learn, work and play.
Find out how RWJF is working to strengthen the systems we rely upon to prevent illness and promote health, and to bring together different sectors to advance new approaches to help all people live healthier lives.
Find out how RWJF is working to strengthen the systems we rely upon to prevent illness and promote health, and to bring together different sectors to advance new approaches to help all people live healthier lives.