The environment in which people are born, live, work, and age has a direct influence on long-term health. Social determinants of health (SDOH) are non-medical factors like the neighborhood one lives in, economic stability, food access, social support, and additional factors in people’s environments—and they drive as much as 80 percent of health outcomes. I see this every day in my work as the executive director of the Medicaid Innovation Collaborative (MIC), where we are working to advance technology and innovations that address health inequities in Medicaid.
The Medicaid market is massive, with over 92 million peopleenrolled, and there is an opportunity for entrepreneurs and the private sector to improve the experience and delivery of care—and ultimately improvehealth outcomes. Earlier this year, MIC held a showcase where finalists, chosen from a pool of over 100 applicants, presented their SDOH technology solutions to Medicaid industry leaders. Here are four of the 13 selected companies, the problems they are working to address, and the solutions they believe will make a difference.
FarmboxRX: Food is medicine
Food insecurity is a healthcare issue. A 2019 study found that food insecure adults had healthcare expenditures that were $1,834 higher than adults who are food secure in America, This resulted in “approximately $52.9 billion in excess health care expenditures associated with food insecurity.”
Nutrition and food insecurity are social determinants that have short- and long-term effects on health outcomes and acutely impacts people on Medicaid—in particular those managing chronic conditions like diabetes or hypertension. Twenty percent of adults on Medicaid report food insecurity. Enter FarmboxRX, where the founders believe food is medicine. The digital health company provides food delivery, tele-nutrition, and the ability to measure outcomes—all in one platform.
FarmboxRX works with health plans to educate members, build personalized nutrition plans based on their health history, and deliver healthy and nutritious food to those who need it. It’s a solution to a pressing issue built on the premise of education, so members know what kinds of foods can best help them manage their health issues and conditions long term. And, so far, it works: a 2021 New Mexico pilot—the same year Farmbox was approved by the USDA to accept SNAP payments online—saw a nine percent decrease in unnecessary emergency room visits with improved health outcomes and a 13 percent decrease in hospitalizations for enrollees in New Mexico.
Benefits Data Trust: Improving access to benefits
One of the things we regularly hear from consumers through our work at MIC is that they know there are many different types of public benefits available but have difficulty accessing them. And the numbers tell the story: over $80 billion in financial assistance, food, healthcare, broadband assistance, and tax credits goes untapped in America. Nine million households are eligible for, but not enrolled in, SNAP. And the long-term effects of this are very real: SNAP saves $1,400 annually per adult in health care costs, improves children’s reading and math scores, and increases graduation rates.
The Benefits Data Trust (BDT) is a non-profit helping people navigate public benefits systems like SNAP and Medicaid. BDT works with a broad network of national government agencies, healthcare entities, and other partners to connect America’s hard-to-reach populations to the benefits they can receive. BDT identifies individuals who are not receiving the food and healthcare benefits they qualify for and then, through SMS reminders and one-on-one phone calls, assists them in applying for and enrolling in those benefits. Since launching in 2005, BDT has submitted over 1.3 million public benefit applications on behalf of individuals and families. And a 2021 study found that BDT’s outreach and assistance made adults over seven times more likely to enroll in SNAP.
The innovation is simple, yet necessary: BDT makes it easier and simpler for people to enroll in social services.
Kaizen Health: Getting people to and from the care they need
Transportation impacts the health outcomes of individuals. Access to convenient and reliable transportation means the ability to receive care, get prescriptions, and attend necessary appointments and check-ups. This is an issue across the entire American healthcare system, with an average of 3.6 million adults missing non-emergency medical care annually because transportation is a barrier.
Since its launch in 2016, Kaizen Health has given people on Medicaid better and more reliable transportation for non-emergency care. The company is a HIPAA-compliant technology platform that works with a nationwide network of transportation, delivery, and logistics partners that brings patients to and from their appointments, and drops off prescriptions and food to their homes.
Kaizen is the air traffic controller working with healthcare providers and payors to ensure patients are not left behind. Transportation is a roadblock to healthcare access and equity, and Kaizen ensures that the country’s most vulnerable get the care and prescriptions they need, when they need them.
Waymark: The community-based care model
The primary care experience can be frustrating for many Medicaid patients. But the start-up Waymark believes community-based care—where patients can receive care in their own home or community—can help improve health outcomes and make primary care more convenient for people on Medicaid.
Waymark identifies the highest risk and hardest-to-reach Medicaid patients and connects them with the care and services they need. What that looks like is different for every patient. Their community health workers are embedded locally and can help patients schedule appointments, coordinate referrals, and more—all from the patient’s preferred location, whether it’s at home, the doctor’s office, or a local coffee shop. The community health workers know that people on Medicaid lead complex lives and communicate with patients however they are most comfortable: in-person, via phone, SMS, or video call.
Waymark trains and hires locally from the communities they serve while acting as a bridge between patients and the Medicaid ecosystem. And it works in getting people on Medicaid to the doctor: studies have shown that community-based care can improve health outcomes with a 56% average reduction in no-shows for clinical appointments.
These are just four innovations in the Medicaid space working to reduce the impacts of SDOH and help people manage their care. They are an example of the solutions and entrepreneurs we are supporting at Acumen America and through MIC as we build momentum and progress towards a more equitable and healthy future.
Veenu Aulakh is the Executive Director of the Medicaid Innovation Collaborative, a program of Acumen America.
