Health Equity & SDoH
Expert articles and analysis related to health equity & sdoh.
AI Summary â Last 30 Days
Medicaid and Medicare VBC policy is increasingly being reframed around how social risk is financed, measured, and operationalized: Medicaid ACOs are using maternal health quality improvement, care coordination, and community-based supports to address disparities, but leaders still face data-sharing, workforce, and sustainable funding barriers (Milbank). At the same time, CMS and states are tightening the fiscal and administrative architecture around equity-oriented Medicaid innovationâincluding new Section 1115 budget neutrality guidance and emerging coverage models such as Indianaâs participation in the federal BALANCE Model for GLP-1 obesity drugsâraising the stakes for ACOs and managed care plans to prove ROI on SDoH, obesity, and maternal-health interventions. In Medicare Advantage, research on social riskâweighted Star Ratings and prior authorization variation by county social vulnerability points to a growing tension for payers: quality and utilization management systems that ignore social complexity may create inequitable performance incentives, while more risk-sensitive scoring could materially shift competitive positioning and bonus revenue.
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