CMS Data on AHC Model Highlights Food as Top Health-Related Social Need

November 2, 2020

The Centers for Medicare & Medicaid Services (CMS) released data on the Accountable Health Communities (AHC) Model, which addresses health-related social needs (HRSNs) through screening, referral, and navigation services that are part of the CMS Innovation Center’s efforts to test new payment and service delivery approaches. The data was based on 750,000 screenings from more than 30 AHC Model participants, including some GNYHA members.

One in three patients (33%) reported at least one HRSN. The most commonly identified need was food, followed by housing, transportation, utility assistance, and safety from interpersonal violence. The AHC data is consistent with the findings of GNYHA members that collect social needs data and also report a high instance of food insecurity among patients.

The AHC data is the most comprehensive collection of social needs data to date from CMS, which will offer a formal evaluation of the AHC Model in 2021. GNYHA will continue following AHC Model findings and other policy initiatives that address social determinants of health (SDH). GNYHA also will continue to help members address SDH through social needs screenings, interventions, and partnerships with community-based organizations (CBOs). Specific GNYHA efforts here include a project to inform contracting between health care organizations and CBOs, the SDH Learning Series, and the SDH Workgroup. GNYHA also continues making critical updates to the Health Information Tool for Empowerment, an online directory of free and low-cost health and social services in New York City, Long Island, and Westchester.