Health network leaders discussed how they’re working to improve social determinants of health (SDOH) and health equity at the 2023 Maryland State of Reform Health Policy Conference.
Angelo Edge, CEO of Aetna Better Health of Maryland, mentioned some incentives the organization is working on to address SDOH, including opening health education centers that focus on them.
“I think the opportunity for collaboration and partnership here are going to set Maryland apart from other states.”
— Angelo Edge, CEO, Aetna Better Health of Maryland
Edge said it is important to understand the unique SDOH challenges to specific regions. Aetna is considering contracting with rideshare organizations, which would fill in gaps for providing non-emergent medical responses. It is also incentivizing providers by paying them coordination fees for conducting patient screenings, coordinating care, and connecting patients to additional resources.
“We pay them on a sub-capitation basis,” Edge said.
Suzanne Schlattman, deputy director of Maryland Healthcare for All, spoke about her experiences conducting community outreach, and the difficulties she has heard about when it comes to accessing services. She said many residents face transportation issues, regardless of where they live.
“In our conversations, we continue to hear [about] prescription drug affordability.”
— Suzanne Schlattman, deputy director, Maryland Healthcare for All
Maryland was the first state in the nation to establish a Prescription Drug Affordability Board, which will set upper payment limits on prescription drugs. Marylanders have yet to experience a drop in their prescription drug prices. Schlattman said prescription drug affordability is a top-of mind concern for consumers, since high prices affect personal and family budgets, which affects whether individuals can afford food or pay rent.
“Because of the costs in healthcare, it is affecting all of these things—[like] which school is your child going to? All of these other pieces come into play,” she said.
The board is working to address SDOH and health equity through workforce development with Nexus Montgomery. The pair are focused on getting individuals certified in hard-to-fill positions, such as certified nursing assistants and certified medical assistants.
“We are covering the tuition for these people who are coming in to get these certifications, and then we’re making sure they’re successful.”
— Schlattman
The organizations are also ensuring participants are successful in certification programs by having community health workers provide hands-on help. When participants complete their programs, the board and Nexus want to ensure career success. Career counseling will be provided, which will include advice about transportation issues, for example. The counselors can also assist participants with advancing their careers so they can earn higher wages in the future.
Natalie Burke, president and CEO of CommonHealth ACTION, said a lack of understanding regarding SDOH and health equity is a primary concern.
“We lack a statewide narrative about SDOH and health equity. It’s happening in pockets, but there has to be a collective consciousness [to] establish what these things are if we want more communities to engage meaningfully in their own health destiny.”
— Natalie Burke, president and CEO, CommonHealth ACTION
Burke said it would be a disservice to the community if the state were not investing in health equity literacy. She added that Marylanders don’t have a full grasp on what they should expect from health equity, and that if it isn’t framed as a basic human need, the state and health leaders are failing.
“We have too many assets in this state that remain untapped,” Burke said.
Burke said part of the issue with lack of understanding is that, while Maryland has a high population of folks who are educated and many academic facilities, there’s a misperception about not needing to invest in health equity like other states do.