Conference Presentation, Panel
Addressing Social Determinants to Improve Health Outcomes
Milken InstituteAnand Parekh, Karen DeSalvo, Esther Dyson, Sergio Matos, Alan Moses, Lydia, Mark Hyman, Helen
- The digital revolution in healthcare is projected to enhance insights into the correlation between addressing social determinants and improving spending efficiency and health outcomes as data analysis capabilities mature.
- Humana anticipates extracting approximately $15 per person monthly by mitigating social isolation and food insecurity, with cumulative financial impact increasing when scaled nationally.
- Interventions targeting social needs are expected to increase "healthy days," defined as self-reported periods where members feel better and more engaged in their communities.
- The Wellville initiative plans to operate as a ten-year project concluding in 2024, focusing on penetration and density within five specific small communities to address 29 contributing factors to health outcomes.
- The project aims to establish "fishing institutions" within the target communities that will sustainably operate independently after the organization's direct involvement ends in 2024.
- Healthcare system transformation is anticipated only when underlying belief systems shift to address power inequalities and equity, otherwise health outcomes are expected to remain static.
- Medicaid redesigns focused on value-based payments are expected to improve outcomes in a limited number of states, while the majority of the United States remains disconnected from such systemic improvements.
- Preventing type 2 diabetes is predicted to require a transition from a medical framework to a social sphere involving changes to daily life structures, school curricula, and community health messaging.
- A critical branch point for the country is expected once CMS actuaries validate a value proposition, leading to funding via healthcare dollars or alternative social care streams.
- Medicare actuaries' requirement for accurate data and guaranteed outcomes is projected to create a barrier to scaling demonstration projects.
- Future strategies are expected to incorporate greater attention to broader determinants through risk adjustment models and strategic community investment in daily operations.
- The CDC is anticipated to update its diabetes prevention program to prioritize modern nutritional advice over traditional low-fat and calorie-counting methods to increase effectiveness.
- Breaking down local barriers and removing politics is expected to generate a pathway for impact to expand from the local level to national and global scales.
- Persistent enforcement of power and unjust inequities by healthcare and social service systems is predicted to continue until these entities adopt greater humility and cease holding power over communities.