RISE looks at recent headlines concerning social determinants of health (SDoH).

 Nonprofit health plans launch Center for Social Determinants of Health Innovation

The Association for Community Affiliated Plans (ACAP) has launched The ACAP Center for Social Determinants of Health Innovation, which will offer tailored resources, including policy reports, market research, and roundtable educational events, to help health plans, policymakers, and other stakeholders address social issues that impact health and wellbeing. The center aims to help reduce health disparities.

“Longstanding racial inequities cannot improve without meaningfully addressing the social factors underlying them,” Margaret A. Murray, chief executive officer of ACAP, said in the announcement. “Safety Net Health Plans have worked in communities across the United States to address factors that shape their members’ health for decades. This new center creates unique opportunities to showcase what works, share that knowledge with others, and support a healthier future for people with low incomes, whose wellbeing has too often been held back by their environment.”

The Center brings together best practices from academia, policy, and the real-world experience of ACAP’s 74-member safety net health plans, which serve more than 22 million individuals with low incomes and significant health needs nationwide. It presents the latest research, policies, and funding opportunities to help strengthen SDoH initiatives and offers educational events, such as discussions on using Medicaid benefits to address beneficiaries’ housing needs.

White House works with private sector to reduce greenhouse gas emissions, protect public health

A joint effort with federal agencies and partners from across the health sector aims to reduce greenhouse gas emissions and prepare facilities and communities for both chronic and catastrophic climate impacts.

At a White House event with the U. S. Department of Health and Human Services (HHS), the Department of Veterans Affairs (VA), and partners from across the health sector, participants pledged to cut their greenhouse gas emissions by 50 percent by 2030 and to achieve net zero emissions by 2050. The event was help on the same day the Supreme Court limited the Environmental Protection Agency’s authority to mandate carbon emissions.

“Nobody should underestimate the importance of federal and private sector health care leaders joining together to address the impacts of climate change,” Secretary of Health and Human Service Xavier Becerra said in an announcement. “Health care providers already see the undeniable risks to their patients, especially those who already face other economic and health disadvantages. With suppliers and pharmaceutical companies helping decarbonize the supply chain, where so much of the sector’s carbon footprint lies, the health sector is getting a significant jump on addressing one of the key issues of our time.”

Denis McDonough, secretary of Veterans Affairs (VA), said that the VA aims to respond to the climate crisis by modernizing facilities, increasing efficiency, shifting to clean energy, and committing to moving VA to a net-zero emission organization.

The participants represent 650 hospitals, numerous health centers, insurance companies, suppliers, professional associations, and other industry stakeholders.

In addition, the White House announced the following new resources to support the health sector in transitioning to clean energy, reducing emissions, and building climate resilience:

Federal health sector emissions reduction resources: These resources include a webinar series to provide education and training on sustainable infrastructure financing, climate emergency preparedness, and emissions tracking from the health sector supply chain.

Federal health network on decarbonization best practices: The VA, Military Health System, and Indian Health Service are launching a coalition to exchange best practices on emissions reduction and climate resilience with a plan to share their learning with private-sector organizations.

National research forum on climate impacts and heart health: In which health care organizations can learn about climate change and the effects of air pollution on cardiovascular health, and to review evidence-based interventions to address those threats. 

Health sector emissions assessment toolkit: The resources from the Agency for Health Care Research Quality aim to facilitate consistent measurement and reporting of health facility emissions data and to provide guidance on transitioning to greener models of care delivery.

Federal funding for climate smart health facilities: The Department of Housing and Urban Development will offer the green mortgage insurance premium, which provide incentives for ongoing care facilities to implement energy and water efficiency upgrades. The program aims to lower costs for renovation and rehabilitation of facilities and increasing the safety of the populations they serve. 

CMS proposed rule aims to expand access to emergency care in rural communities

The Centers for Medicare & Medicaid Services (CMS) has released a new proposed rule that protects access to emergency care and additional outpatient services for people in rural communities.

The overall policy goal of the proposed rule is to establish Conditions of Participation for rural emergency hospitals (REH). The proposed rule will allow small rural hospitals to seek this new health care provider designation and provide continued access to emergency care, observation care, and additional medical and outpatient services. They will be eligible to receive payment for services provided or after January 1, 2023.

Rural communities represent a fifth of the U.S. population yet have limited health care resources. Since 2010, 138 rural hospitals have closed—with a record-breaking 19 hospitals closing in 2020 alone, CMS noted. These closures occur disproportionately within communities with a higher proportion of people of color and communities with higher poverty rates. Rural communities experience shorter life expectancy, higher mortality, and have fewer local health care providers, leading to worse health outcomes than in other communities. Rural hospital closures deprive people living in rural areas of crucial services, including access to emergency care.

“The availability of the new Rural Emergency Hospital provider type will maintain access to essential health care services and help to reduce disparities in rural communities,” CMS Administrator Chiquita Brooks-LaSure said in the announcement. “CMS is committed to advancing health equity, driving high-quality person-centered care, and promoting the sustainability of our programs. Today’s action to strengthen rural health furthers our goal of ensuring everyone served by our programs the has access to quality, affordable health care.”

To address these concerns, CMS will implement a new Medicare provider designation called REHs, which will provide an opportunity for small rural hospitals and critical access hospitals to right-size their service footprint and avoid potential closure so they can continue to provide essential services for their communities. The REH provider type was established by the Consolidated Appropriations Act of 2021 to address the growing concern over closures of rural hospitals.

Allowing providers to take advantage of the new designation will ensure that people in rural communities will be able to receive critical outpatient services, including emergency, maternal health, behavioral health, and substance use disorder services.

For more information, click here for the proposed rule, here for a fact sheet, and here for the announcement.