Medicare to test if seamless social work can improve health

Doctors, community workers and social researchers have long recognized a link between the hardships of poverty and health problems.

Now the government is launching an experiment to see if seamless social work can improve the health of vulnerable Medicare and Medicaid recipients, and perhaps even lower costs, by heading off emergency room visits and hospitalizations.

The Department of Health and Human Services on Tuesday announced a five-year, $157 million grant program for as many as 44 organizations that will work to link patients with social services they may need, be that housing, transportation, Meals on Wheels, or help to deal with domestic abuse.

The government is calling the program "Accountable Health Communities." If it shows promise, it could be expanded nationwide.

Patrick Conway, Medicare's chief medical officer, said that as a pediatrician he had personally dealt with what experts call the "social determinants of health." It could be a youngster with asthma whose family lives in a roach-infested apartment, and who keeps going back to the emergency room because substandard living conditions aggravate the disease.

The groups awarded grants under the program will serve as a bridge between participating doctors or hospitals and social service organizations in the community. Medicare and Medicaid beneficiaries will be screened for social needs and—at minimum— referred to agencies that can help. Some patients will get active shepherding.

The grants will be awarded this fall, and the program is expected to commence early next year. President Barack Obama's health care law gave Medicare and Medicaid broad authority to carry out such experiments. It will be up to Obama's successor to determine if this one works, and whether it's worth building on.

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