CMS Issues New SDH Guidance for States

January 19, 2021

The Centers for Medicare & Medicaid Services (CMS) recently issued new guidance for states adopting social determinants of health (SDH) strategies in Medicaid programs. The guidance is part of CMS’s efforts to reform service delivery models, address the social needs of beneficiaries across all programs, and broadly advance value-based care initiatives.

The guidance summarizes services and supports covered under Medicaid, including non-medical transportation, home-delivered meals, housing assistance, education, and employment services. Additionally, it provides service descriptions and examples, plus details on potential target population and Federal authorities that can be used to cover services. The guidance also encourages states to use telehealth for appropriate services and flexible reimbursement methodologies to meet state-specific policy goals and priorities.

The guidance aligns with the SDH intervention requirements in New York State’s current Value-Based Payment Roadmap and the SDH strategies of GNYHA member hospitals. GNYHA is engaged in various efforts to help members implement SDH interventions and related partnerships with community-based organizations, including the SDH Workgroup; SDH Learning Series; and the Health Information Tool for Empowerment (HITE), a publicly available online directory of health and social service organizations in New York City, Long Island, and Westchester County. GNYHA will continue to support members in their SDH initiatives and help them follow related State and Federal policy updates.