Florida health leaders highlighted initiatives aiming to address key social determinants of health (SDOH) challenges, like housing insecurity, at the 2024 State of Reform Health Policy Conference in April.
Jake Rothstein is the founder and CEO of Upside, which collaborates with health plans to connect those in need with stable, affordable housing options.
“For years, we’ve heard about housing being a problem (with) the costs, zoning, building, and health plans spending a lot of dollars on building infrastructure,” Rothstein said. “Recently, we’ve seen the tone change from talking about problems to trying to figure out solutions. I think legislation will follow that. There’s a lot of initiatives at the national and local levels trying to create programs that are going to be long-term; not just grant-funded programs that will last 12 months.”
Upside built a network of curated apartment communities and single-family homes on a national scale that provides real-time pricing availability and unit information, Rothstein said.
“We are able to match the demand that comes from the health plan for housing unstable individuals with real-time information on supportive housing,” he said. “We work with Medicare, Medicaid, and dual-eligible populations. There’s a lot of lowercase affordable housing that’s appropriate for Medicaid recipients. We can facilitate their entry into those units.”
Aetna Better Health of Florida Vice President Jennifer Sweet said the health plan has been building infrastructure to meet a variety of SDOH needs.
“We have been seeing on a national level—Aetna has 17 plans across the country—a very well-worn path on food and housing supports. In Florida, we have been very aggressively building the infrastructure to support the varied needs, beyond housing and food (the big ones), to make sure our members get workforce training, loneliness support, and we have things for all ages.”
— Sweet
Aetna helps provide these services by partnering with community-based organizations, and providing wraparound services under Medicaid, Sweet said.
“[It’s] knitting together what they offer and what the member needs to enable a better health outcome,” she said. “This is becoming a well-worn path and I think the next step we’re working on is to put ourselves into a pivotal role where we can fortify and extend the social safety net that exists in a very fragmented way. That’s what I see as the stage that’s not fully exploited, but we are at the threshold of doing that. And that’s going to be a very important advancement for members, the state, and taxpayers.”
Dr. Janisse Schoepp, chief strategy officer for the Health Foundation of South Florida, said the foundation’s work has transitioned into focusing more on SDOH to advance its mission over the years.
“Because we understand that more than 80 percent of what results in poor health outcomes happens outside of clinical walls. We have also begun to invest in policy and system change efforts because we want our efforts to be sustained over time.”
— Schoepp
Schoepp said the revisiting of hospital community benefit requirements that occurred under the Obama administration provided an opportunity for health leaders to address SDOH.
“That opened the door for us to have conversations with the hospital systems around strategies that now fit under this community building category, which has to do with economic and community development, and provides the opportunity to address housing and the like,” she said. “And there’s a lot of untapped opportunity there because the investments are still not being made. But if we were able to shift hospital investments in that category, we’re now investing in the infrastructure that we need to create healthier communities.”
Savannah Cleveland Queen, customer and community success manager at findhelp—which helps connect organizations to SDOH resources and tracks SDOH outcomes—noted that technology can help health officials address SDOH as well.
“Findhelp.org is a free platform that anyone can navigate to find free and reduced-cost resources in your area,” Cleveland Queen said. “We’re industry agnostic. No matter what industry you work in, there are social needs. We partner with a lot of health plans on SDOH. We have data on what people are searching for in any given community, and what their needs are.”