SDoH Newsletter No. 8 - Winter 2022 by WilmingtonFRA

RISE News

Seema Verma to present keynote at RISE’s 2022 Summit on Social Determinants of Health Former CMS Administrator will share insights on high value, low-cost health care

The RISE Summit on Social Determinants of Health: A day-by-day preview for our return to Nashville

New year, same rural health challenges

New safety protocols at play

Nº8 - Winter 2022

THE LATEST NEWS Feds issue new guidance to boost accessibility, equity in COVID-19 vaccine programs

KFF survey: State Medicaid program efforts to reshape policies in response to pandemic help further address SDoH, health equity

SDoH in the news: CMS takes steps to improve maternal care outcomes; Mental health continues to take a toll amid pandemic; and more

SDoH in the news: Wearable health devices “game-changer” for clinicians; Efforts to address SDoH increase cancer survival rates, close gaps in racial inequities; and more

Medicaid Managed Care programs enable states to address SDoH, report finds

RWJF Commission releases recommendations to transform public health data systems, announces $50M in grant funding toward initiative

Advocacy group urges CMS to allow MA plans to add benefits that address social determinants of health

How Nashville General Hospital is addressing SDoH, promoting health equity

California joins states trying to shorten wait times for mental health care

Blue Cross Blue Shield of Massachusetts to offer financial incentives to physicians who improve care for people of color

The Commonwealth Fund releases new health equity scorecard, reveals profound racial, ethnic health disparities across all states

Racism a strong factor in Black women’s high rate of premature births, study finds

Strategies for health plans to achieve health equity

SDoH in the news: HHS awards nearly $1B in American Rescue Plan funding to support vulnerable communities; SAMHSA distributes $825Min grants to CMHCs; and more

How rural communities are losing their pharmacies

READ OUR ENTIRE COLLECTION OF INSIGHTS AND ARTICLES 2

SDoH COMMUNITY NEWSLETTER

Letter From the Chair

NEW YEAR, SAME RURAL HEALTH CHALLENGES

A major ripple effect has emerged for patients and providers in rural regions. As rural hospitals continue in peril, so do the communities that rely on them. Close to 200 rural hospitals have closed over the past 16 years, with an additional 20 percent at risk of closure. More than seven percent of babies born in the U.S. are birthed at “low-volume hospitals,” and in the context of the fiscal priority of our industry, that number seems a relatively low amount. For the women and families enduring these pregnancies, this dearth in care becomes a major quality area for attention, as well as a fight against morbidity and mortality. A look at the facts: • More than a third of hospitals with obstetrics units in the U.S. are referred to as “low volume,” meaning they have 10 to 500 births annually. This is compared to those facilities of 501-1000 births, 1001-2000 births, or those with more than 2,000. • Nearly 19 percent of low-volume facilities were not within 30 miles of any other obstetric hospital and nearly 24 percent were within 30 miles of a hospital with more than 2,000 deliveries per year. The most isolated hospitals were frequently low volume, with 58.4 percent located in very rural areas. • Of those remaining facilities, less than 50 percent have an obstetric unit. • The end result? Greater risks for mother and baby and

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an increased potential for medical trauma. The concerns in rural regions lacking such services have been, and continue to be, massive: Births in hospitals without OB specialists or necessary care cause neonatal intensive care units for preterm births to be even less available Less than 50 percent of rural counties have a practicing OB/GYN, which increases the likelihood of maternal and infant mortality fourfold, as women are 30 percent more likely to hemorrhage after delivery in rural hospitals with the lowest number of deliveries. Decreased access to OB/GYN providers and clinics means fewer women accessing prenatal care, causing a lack of awareness specific to critical factors that complicate the pregnancy and compromise a health delivery, such as anemia, gestational diabetes, blood pressure, or a baby in the breech position. A dearth of post-partum care yields increased concern for proper assessment and intervention for factors such as post-partum depression.

Finances are a major player in the decision-making process to maintain necessary specialty services for patients in any region. Let’s keep in mind, 50 percent of all rural births are paid for by Medicaid, which provides far less reimbursement than commercial insurers. Closing these critical hospital services is not the answer. Expanding funding has been among CLICK TO SEE OTHER ARTICLES

the recommendations. Something must shift before limited access to care becomes even more of an acceptable co-morbidity for residing in a rural community.

consistently show upwards of 20 percent of readmissions are medication related, often due to lack of patient ability to access them.

The expansion of “drugstore deserts” is another emerging gap in rural care:

CVS plans to close 900 pharmacies in the next three years to expand more lucrative offerings, such as health care services and digital health. One wonders how many brick and mortar pharmacies will be left?

• More than 41 million people are struggling to access their prescriptions or other over the counter medications • More than 1,230 independently owned rural pharmacies have closed since 2005, 16 percent of all pharmacies across the U.S. • More than 630 communities have no retail store with a pharmacy • Twelve percent of Americans are forced to drive more than 15 minutes to reach the closest pharmacy or lack enough pharmacies to meet medication demands in more than 40 percent of counties The age of the corner or independent drugstore is eroding due to causal factors related to competition with price savings of vertical mergers of drugstore chains, insurance companies, and pharmaceutical benefit managers. Insurers want low pricing, which hits smaller pharmacies hard. Fifty percent of drug plan reimbursements fail to cover the costs of drugs and their overhead. However, the most vulnerable patients still suffer the most with increasing barriers to accessing needed medications. Some of the most significant challenges stem from hampered medication access from ongoing postal delays, ongoing digital chasms, including limited rural broadband and Wi-Fi-access, and a lack of digital device availability or proficiency with usage. And let’s not forget that with health care access more limited in rural areas, a local pharmacist might serve as a default medical provider, offering basic guidance. Studies

So, what are the funding options? New funding is on the horizon to mitigate gaps in the expanding rural health quandary of care. I urge you to explore our comprehensive funding guide, an exclusive resource for RISE SDoH community members. For rural health funding specifically, be sure to explore the Rural Health Information Hub, the USDA’s Emergency Rural Health Care Grant, and the Health Resources & Services Administration’s Federal Office of Rural Health Policy’s newest funding opportunities. All of which can be found in our funding guide. The 2022 RISE Summit on Social Determinants of Health Our SDoH world continues to evolve as does our community, now over 2,000 members! The RISE Summit on Social Determinants of Health is on the near horizon, taking place March 20-22, 2022, live in Nashville! Both rural and maternal health are among the many topics which will be discussed at this exciting event. I hope to see you there. For now, stay safe and take good care!

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CCTP, CMHIMP, CRP, DBH(s) Social Determinants of Health Community Chair The RISE Association

SDoH COMMUNITY NEWSLETTER

Seema Verma to present keynote at RISE’s 2022 Summit on Social Determinants of Health KEYNOTE ADDRESS SPONSORED BY

ormer CMS Administrator Seema Verma will share insights on high value, low-cost health care at The RISE Summit on Social Determinants of Health on Monday, March 21 at The Omni Nashville.

Seema Verma, former administrator, Centers for Medicare & Medicaid Services (CMS), will kick off the first day of the 2022 RISE Summit on Social Determinants of Health, discussing effective approaches to meet the needs of vulnerable populations within a value-based health care system. Her keynote presentation is sponsored by Wellsky. As the longest-serving CMS Administrator in modern history and a national health policy expert, Verma will offer her insights on the tactical ways health care organizations can address social determinants of health (SDoH) problems within the framework and resources in our health care system.

During her time at CMS, Verma implemented over 16 strategic initiatives aimed to lower costs, improve quality, and increase access in the U.S. health care system. She also worked to accelerate value-based care transformation and address SDoH by advancing new payment models throughout CMS programs, dropping premiums in Medicare Advantage, Part D, and the insurance exchanges. Verma’s keynote will take place at 8:45 a.m. Monday, Mar. 21, at The Omni Nashville, Nashville, Tenn. Her presentation will explore the concept of high value, low-cost health care to meet the needs of vulnerable populations within a value-based health care system. The RISE Summit on Social Determinants of Health will be held Mar. 20-22, at The Omni Nashville in Nashville, Tenn. Preconference workshops and an opening reception will take place on Sunday, Mar. 20, followed by the main conference. Click here to download a brochure, see the agenda, and view a complete list of speakers. ◆

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A day-by-day preview for our return to Nashville

The annual event will be held live at The Omni in Nashville, Tenn., March 20-22. Here’s a look at what we have planned so far for preconference workshops, networking opportunities, keynote presentations, general sessions, track sessions, and our health and safety protocols.

SDoH COMMUNITY NEWSLETTER

RISE is excited to reconnect cross-sectional stakeholders from payers, providers, community-based organizations (CBOs), and funders at the 6th annual RISE Summit on Social Determinants of Health to discuss actionable, scalable solutions to address social determinants of health (SDOH) and achieve better outcomes. With more content offered than ever before–28 thought-provoking sessions–and our biggest speaker lineup yet–more than 75 changemakers will take the stage–this year’s event will equip attendees with unparalleled connections, strategies, and lessons learned to further the drive for social good. Here’s a look at the preliminary agenda:

SUNDAY, MARCH 20 The summit will kick off with three hands-on preconference workshops from 1:30 p.m. to 4:30 p.m. facilitated by industry leaders. During the CBO Bootcamp workshop, industry leaders will help CBOs determine whether they’re ready to partner with stakeholders such as health plans, health care providers, and

public health entities to address SDoH and how they can best meet their demands. Participants will explore staffing challenges, contracting insights with a focus on value-based care, and lessons learned during COVID-19 and how to prepare for the future. The second workshop will address the social determinants of mental health (SDoMH) and transforming the way communities support and address mental and behavioral health services. The workshop will dive into Adverse Childhood Experiences (ACEs) and their impact on communities; the emotional, physical, and mental health side effects of unresolved trauma; strategies to align behavioral health providers toward a shared vision; and unique populations, such as active-duty military and veterans, who face diverse SDoMH. The third workshop, poverty’s hidden impact on the brain, will be part workshop, part hands-on game as participants experience firsthand how your own brain changes in poverty as you play the ‘Getting’ By’ game. The workshop will offer insights into how brains cope with scarcity and how it affects a person’s ability to be healthy and, more importantly, receive help. The day will wrap-up with a networking cocktail reception from 4:30 p.m. to 6 p.m.

MONDAY, MARCH 21 We’ll start the day with registration and a networking breakfast. The first conference session will be with Seema Verma, the longest-serving CMS administrator in modern history, who will deliver a keynote address, sponsored by WellSky, on high value, low-cost health care and how to meet the needs of vulnerable populations within a value-based health care system. Verma will share tactical ways health care organizations can address SDoH problems within the framework and resources in our health care system. We’ll then hear from a panel of industry experts on innovative financing mechanisms to address SDoH. Panelists will discuss examples of successful funding models; how organization are incorporating SDoH incentives into value-based agreements and outcomes-based payments between health plans, providers, and CBOs; and their outlook for reimbursement in 2022. Next, we’ll hear from a diverse policy panel who will share insights into the current and future happenings at the federal level. The session will offer an update on what’s happening on the Hill as it relates to SDoH, a look at how lawmakers have decided to take SDoH to a new level, ways health plans can leverage federal health programs and social needs care to ensure a healthier future for all, and how to advance future policy solutions and how stakeholders can make an impact. During a spotlight session on successes at the state

level, public health leaders from Tennessee, Florida, and Massachusetts will share their stories of successful public/ private partnerships. They’ll also discuss how to strengthen community-clinical linkages through increasing partnerships amongst stakeholders, ways the private sector can use publicly available data sources to address health equity challenges, and innovative programs that could be scaled in other communities. During a networking lunch, attendees will be able to join leading vendors in the SDoH space in a Tools & Technology Spotlight in the Exhibit Hall to learn about the latest and greatest technology solutions. After lunch, we’ll break into concurrent track sessions from 1:15 p.m. to 4:45 p.m. Throughout the afternoon, attendees will be able to choose from the following sessions: • Systemic collaboration to improve maternal and child health outcomes • A health care provider’s mission to end racism as a social determinant • Addressing food insecurity for seniors during COVID-19 • Successful public/private partnerships at the local level • The intersection of housing and maternal and child health that will share results from an ongoing project with CareSource and Nationwide Children’s • Sustainable community care coordination model that works • Baltimore Housing Mobility Program that aims support low-income families to access opportunity areas • Expanding and scaling SDoH efforts to improve outcomes by using clinically validated data points, a multi-level evaluation approach, and a maturity model to map your journey • Improving social connectedness in older adults improves health • Addressing digital health equity through direct-toconsumer telemedicine Attendees will join back together at 4:45 p.m. for a general session on collaboration across systems. Industry leaders will discuss how the city of Nashville leveraged its providers, institutions, and civic leadership to provide equitable care to its people during the pandemic. Conference Chair Ellen Fink Samnick, chair, RISE SDoH Community, will then announce the recipient of the inaugural Health Care Hero Award. Following the award ceremony, the evening will close with a networking cocktail reception from 5:45 p.m. to 6:45 p.m.

TUESDAY, MARCH 22 Following a networking breakfast at 8 a.m., Kevin Coleman, empowerment coach and trainer, KMC EMPOWERMENT CLICK TO SEE OTHER ARTICLES

LLC, will take the stage for a candid conversation about diversity, equity, and inclusion (DEI). Throughout the interactive session, Coleman will explore how to create an inviting DEI culture within your organization, how to recognize your own unconscious bias and how to prevent it in your organization, and how to recognize microaggression and macroaggression and the effective best practices to eliminate them. A panel of industry leaders will then discuss how the future of networks is social and how to create pathways to sustain SDoH services. Panelists will discuss the critical elements needed to support scaling a sustainable social services delivery system, the key steps to achieve an optimally functioning and adequately resourced social services delivery network, and how shared governance and coordination across stakeholders can contribute to scalable and sustainable community-led efforts. We’ll hear unique perspectives from health plan leaders who will share their experiences with scalable steps to achieve health equity within their organizations and communities. The panel will share their own projects focused on gathering race and ethnicity data, what’s worked and what hasn’t, and lessons learned to bring back to your own organizations. After networking over lunch, attendees will choose between concurrent tracks from 1 p.m. to 2:30 p.m. The track sessions will include:

SDoH COMMUNITY NEWSLETTER

• Disrupting the cycle of the criminal system and lessons learned from the Cook County Jail • Educating our children in a high stress world and how social and emotional learning leads to school and lifetime success • SDoH identification, ICD-10 documentation, and the next evolution in Medicare Advantage methodologies • Cross-sector collaboration addressing social, health care, and environmental factors for individuals living with diabetes • Driving action, attention, and resources upstream through cross-sector community partnerships Attendees will join together for a final general session back by popular demand with Kathleen Ellmore, managing director, Engagys, who will speak with a panel of consumers affected by SDoH to hear direct feedback around their experiences, access to care, and ways health plans can improve services. RISE is excited to welcome you back to Nashville and in-person events. To ensure the health and safety of attendees, speakers, exhibitors, and staff, proof of full COVID-19 vaccination status is required to attend The RISE Summit on Social Determinants of Health. See the next page for the complete list of health and safety protocols and what you need to know before you make your travel arrangements. ◆

RISE is excited to return to in-person conferences. To ensure the health and safety of attendees, speakers, exhibitors, and staff, RISE will require proof of full COVID-19 vaccination status to attend the events. Here’s everything you need to know before you make your travel arrangements.

Please note that these protocols may vary depending on the state where the event is taking place and the legislation implemented by that state. Please visit specific conference websites to learn what will be expected at each event. RISE is pleased to announce a return to live events with conferences planned all over the country. Before you register for our upcoming conferences, be aware that our health and safety protocols for the events have changed. Please note that these protocols may vary depending on the state where the event is taking place and the legislation implemented by that state. Please visit specific conference websites to learn what will be expected at each event. CLICK TO SEE OTHER ARTICLES

Until further notice, in-person events require:

PHYSICAL DISTANCING

PROOF OF COVID-19 VACCINATION

A person is considered fully vaccinated*: • Two weeks after his or her second dose in a two-dose series, such as the Pfizer and Moderna vaccines, or • Two weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine A physical copy of the Centers for Disease and Control Prevention’s (CDC) COVID-19 vaccination card or a photo of the card, along with a photo ID, will be accepted as proof of vaccination at the registration desk.

* This guidance applies to COVID-19 vaccines authorized for emergency use by the U.S. Food and Drug Administration (i.e., Pfizer-BioNTech, Moderna, and Johnson and Johnson (J&J)/ Janssen COVID-19 vaccines).

FACE COVERINGS

All individuals are required to wear face coverings in accordance with CDC recommendation. Masks are required in indoor conference spaces except for when attendees are eating or drinking and, in a location, where they can maintain a minimum distance of six feet between other attendees.

HEALTH SCREENINGS

RISE encourages physical distancing through a color-coded system for attendees to self-select their comfort level for interacting with others.

ADDITIONAL SAFETY MEASURES Limited seating: All conference sessions will be set up with limited seating per table. Food and beverage protocols: All food and beverage items will be individual servings or served by hotel staff. Networking: RISE has instituted a color-coded system to allow attendees to self-select and display their comfort level for interacting with peers: • Green means you are okay with high-fives and handshakes and interacting close to peers. • Yellow means you are interested in interacting but would like some distance between peers. • Red means you prefer no contact and ask that peers stay at least six feet apart. Exhibitor hall: All exhibitors are asked to set up their exhibit booths with physical distancing in mind, as well as provide a touchless experience so attendees can comfortably interact and shop for solutions. Speaker podiums: All speaker podiums will be physically distanced from attendees; therefore, speakers will not be required to wear a face covering while speaking. For panel sessions, panelists will be physically distanced and all AV equipment will be sanitized after each session. Friendly reminders: RISE will place signage throughout the event to serve as friendly reminders of event protocols.

Upon arrival, attendees must certify several statements upon check in, indicating they have not been exposed to COVID-19 in the past 14 days and are not experiencing any symptoms.

HAND SANITIZING

Hand sanitizing stations will be set up throughout the event in conjunction with the CDC recommendation of thorough hand washing. 10

SDoH COMMUNITY NEWSLETTER

Not feeling well? If you aren’t feeling well or have reason to believe you may have been exposed to COVID-19, RISE strongly urges you to follow the CDC guidelines for self-quarantine and not travel. ◆

UPCOMING EVENTS It Matters To This One: Achieving Better Health Outcomes Through Social Determinants of Health February 10, 2022 | 1:30 pm EST A RISE Association Webinar in Partnership with Centauri Health Solutions

RISE National 2022

VISIT THE EVENT WEBSITE

March 7-9, 2022 Nashville, Tenn.

The RISE Summit on Social Determinants of Health March 20-22, 2022 Nashville, Tenn.

The 7th Annual Medicaid Managed Care Leadership Summit April 26-27, 2022 A Live-Streaming Virtual Event

The RISE Women in Health Care Leadership Summit May 22-24, 2022 Asheville, N.C.

The RISE Value-Based Contracting Summit

VISIT THE EVENT WEBSITE

May 25-26, 2022 Chicago

QUESTIONS? REACH OUT TO OUR TEAM

Ilene MacDonald Editorial Director imacdonald@risehealth.org

Tricia Rosetti Content Marketer trosetti@risehealth.org

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