How Medicare Advantage Programs Can Address Social Risk and Improve Health Outcomes

HIT Consultant December 23, 2024
Brian Norris, Managing Director of Strategic Consulting at MedeAnalytics

There are almost 33 million people enrolled in eligible Medicare programs. Nearly half are enrolled in Medicare Advantage (MA) plans, and that number is expected to continue its climb. While many MA plans offer services that align with social determinants of health (SDOH) goals, there are still gaps in how these services reach and support vulnerable populations. This challenge is multifaceted. Critical issues include:

1. An incomplete understanding of how MA services impact different SDOHs for at-risk populations and contribute to beneficiary outcomes
2. How to best integrate social risk into the value-based care model is unclear, leading to a misalignment between payments and goals
3. Insufficient training for clinicians on social risk within care settings, available programs for Medicare patients,...

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