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Social needs program for Medicaid beneficiaries can be effective but costly, research finds


Nick Casberg Dive Brief:

Programs focused on social determinants of health for Medicaid beneficiaries might reduce unnecessary healthcare use, but might also end up costing health systems more than they save in the long run, according to new research published Tuesday in the Annals of Internal Medicine.

Researchers analyzed how a case management program for patients in California impacted healthcare utilization and costs, and found those enrolled had fewer inpatient hospitalizations and emergency department visits than those not enrolled.

But program expenses were nearly $22.4 million in 2019, and savings — about $3.4 million annually — covered just 17% of the program’s cost, according to the report.

Dive Insight:

Healthcare organizations in recent years have increased their focus on social determinants of health, or the way a patient’s lifestyle and access to needed resources can influence their health and how much money is spent on their medical care.From 2017 to 2019, hospitals spent $2.5 billion on programs focused on offering patients help finding housing, employment, education, food and other resources, according to a 2020 study published in Health Affairs.Health disparities became even more pertinent during the pandemic as COVID-19 has disproportionately claimed the lives of people of color and […]

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