Timely Medicaid Discussion Showcased Value of Integrated Social and Clinical Care

Top health policy experts, with a range of perspectives on how Medicaid and related payor programs can more effectively address both clinical and social drivers of health, headlined a special convening recently. Organized by the Institute for Policy Solutions (IPS) at Johns Hopkins School of Nursing, “The Boundaries of Health: Debating the ROI of Programs and Policies that Integrate Social and Clinical Care,” is timely as the administration and members of Congress debate funding cuts that could undermine efforts to address the harmful social determinants of health that drive costly health inequities.

“How do we realign our health care system, so it meets the needs of the people it serves? This is an important conversation that we need to have on the road to eliminating health inequities, a sustainable fix for our nation’s broken health system—and it was an enormous honor to have this conversation in the context of Medicaid with such an esteemed group of leaders,” said moderator/panelist Dr. Vincent Guilamo-Ramos, PhD, RN, FAAN, IPS Executive Director and Leona B. Carpenter Chair in Health Equity and Social Determinants of Health at Johns Hopkins School of Nursing. “Medicaid is central to the health care of almost 80 million people in the United States, and there’s mounting evidence to suggest that if its programs redefined the traditional boundaries of health to more deliberately and precisely integrate aspects of social care with clinical care, health outcomes would likely improve, and costs would decrease.”

Joining Guilamo-Ramos were leading experts in health policy and program delivery: Kate McEvoy, JD, Executive Director, National Association of Medicaid Directors; Chris Pope, PhD, Senior Fellow, Manhattan Institute; and Kody Kinsley, MPP, IPS Senior Policy Advisor and former secretary of the North Carolina Department of Health and Human Services.

During the convening, the panelists explored and clarified the definitions of effective integrated clinical and social care;which stakeholders should be involved; who should pay for integrated models of care; evaluated the implications for workforce training; and why integrated clinical-social care has not yet fulfilled its full potential. The panelists alsoimagined the potential impact of such an approach as part of a comprehensive realignment of the health and health care system—which includes reforms in payment, delivery, and a more representative health workforce; and, highlighted the consequential role that nurses play in evolving our health care and health system to more effectively deliver on the promise of integrated clinical and social care.

“Our nation needs a new approach to health that realigns our current health system from a fee-for-service profit focus to a people-centered health outcomes focus. The evidence suggests that integrated clinical and social care done right—which means deliberately and precisely integrating aspects of health-related social care with clinical care—would be a game changer in achieving optimum health for all and cost savings all around,” said Guilamo-Ramos.

The discussion offers new thinking and valuable insights for health care, policy, and legislative professionals navigating complex decisions around health care policy, program design, and financing. The entire convening can be viewed here.