Accounting for Social Risks in Medicare and Medicaid Payments

Commonwealth Fund February 1, 2023
Robert L. Phillips, Jr., Andrey Ostrovsky

Toplines

Policymakers, health system leaders, payers, and patient advocates are exploring adjustments to Medicare and Medicaid provider payment to account for patients’ social needs

It’s not enough for clinicians to be asked to assess patients’ social risks; they need tools to be able to respond

There is increasing pressure on frontline clinicians, particularly those in primary care, to assess patients for social needs — for instance, poverty, housing instability, food insecurity, and unemployment — which can be potent drivers of health outcomes. While identifying these needs is important, without resources to address them directly or the ability to partner with community-based organizations, clinicians are left powerless. Being pushed to assess without resources can be a source of frustration and burnout...

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