CMS issued guidance to state health officials designed to drive the adoption of strategies that address the social determinants of health (SDOH) in Medicaid and CHIP so states can further improve beneficiary health outcomes, reduce health disparities, and lower overall costs. SDOH describes the range of social, environmental, and economic factors that can influence health. The new guidance describes how states can leverage existing flexibilities under federal law to tackle adverse health outcomes that can be impacted by SDOH and supports states with designing programs, benefits, and services that can more effectively improve population health and reduce the cost of caring for the most vulnerable and high-risk populations.
SDOH can affect health care utilization and cost, health outcomes, and health disparities. For example, the on-going COVID-19 pandemic has exacerbated long-understood disparities in health outcomes among low-income populations, particularly children. Recent Centers for Disease Control and Prevention data indicate that counties with greater social vulnerability, including high poverty rates and crowded housing units were more likely to become COVID-19 hotspots, potentially putting those who experience economic and housing constraints at a higher risk of contracting the virus.