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Eat! You’ll Feel Better

And maybe need to spend less on health care.

That is the lesson learned from a program in Massachusetts that provided home delivery of food to dually eligible Medicare/Medicaid recipients who were struggling with their meals.

In a limited experiment, selected individuals received home delivery of food:  some received general meal deliveries while others received food tailored to their individual medical conditions.  The purpose:  address a major social determinant of health in this difficult-to-serve population.

The result, according to a report published in the journal Health Affairs, was that

Participants in the medically tailored meal program also had fewer inpatient admissions and lower medical spending. Participation in the nontailored food program was not associated with fewer inpatient admissions but was associated with lower medical spending. These findings suggest the potential for meal delivery programs to reduce the use of costly health care and decrease spending for vulnerable patients.

Learn more about the program and its results in the Health Affairs article “Meal Delivery Programs Reduce the Use of Costly Health Care in Dually Eligible Medicare and Medicaid Beneficiaries,” which can be found here.…

Tackling Social Determinants of Health

The growing awareness of the impact of social determinants of health comes at a time when health care providers are assuming unprecedented degrees of risk for the health of their patients, leaving many providers wondering how best to invest resources that will meet both their own needs as well as the needs of their high-cost, high-need patients.

A new document from the Commonwealth Fund, “Investing in social services as a core strategy for healthcare organizations:  Developing the business case,” seeks to serve as a manual for providers seeking to move into this relatively new territory.

The report takes providers through key steps in the process, including establishing a common definition of social service investment; identifying common barriers to social service investments; and building the business case for such investments.  It also addresses six aspects of building that business case:

  • identifying potential social investment options
  • defining success
  • measuring costs
  • determining an investment model
  • developing a return on investment approach
  • sensitivity analysis and investment launch

Finally, it identifies the major social determinants of health providers might seek to address:

  • economic stability
  • neighborhood and physical environment
  • education
  • food
  • community and social context

For a closer look at the considerations that go into the …

Primary Care Spending Declines Amid Health Care Cost Rise

At a time when health care costs continue to rise, spending for primary care is declining.

This is the conclusion of an analysis of Health Care Cost Institute Data published on the Health Affairs Blog.

According to the analysis, spending on primary health care declined six percent between 2012 and 2016 – more than twice the rate of the decline in spending for any other type of care.

These results concern analysts because research shows that investment in primary care services generally improves population health at less cost.

The decline is in utilization, not price, and while the reasons for decreased utilization are not certain, among the factors are thought to be high-deductible insurance plans, increased cost-sharing, greater use of urgent care, and a general preference for specialist services.

Learn more about the data, the trend, and its implications in the Health Affairs Blog report “Disinvesting in Primary Care,” which can be found here.…

Community Health Center Patients Often Have Housing Problems

Nearly half of the patients served by community health centers have housing problems, according to a new report published by the Journal of the American Medical Association.

Among those problems:  two or more homes in the past year alone, difficulty paying their rent or mortgage, and homelessness.  Some have homes that are not their own.

Practitioners need to understand this and help patients address their housing challenges, the study suggests, because housing concerns often prevent such patients from complying with medical instructions.

Learn more about how housing challenges affect health and health care in the JAMA report “Prevalence of Housing Problems Among Community Health Center Patients,” which can be found

Nearly half of the patients served by community health centers have housing problems, according to a new report published by the Journal of the American Medical Association.

Among those problems:  two or more homes in the past year alone, difficulty paying their rent or mortgage, and homelessness.  Some have homes that are not their own.

Practitioners need to understand this and help patients address their housing challenges, the study suggests, because housing concerns often prevent such patients from complying with medical instructions.

Learn more about how housing challenges …

Senators Push IRS on Non-Profit Compliance

Two prominent senators have written to the Internal Revenue Service seeking information about what the agency is doing to ensure that non-profit hospitals comply with the requirements for providing sufficient community benefits to justify their tax-exempt status.

 Senators Orrin Hatch (R-UT), chairman of the Senate Finance Committee, and Chuck Grassley (R-IA), a senior member of that committee, have asked the IRS to provide their committee with specific information about how the IRS evaluates non-profit hospitals’ Form 990 Schedule H; about guidance the IRS provides regarding how hospitals define their communities and their communities’ needs; about the performance and outcome of IRS reviews of individual non-profit hospitals’ compliance with legal tax-exemption requirements; and about the status of the IRS’s anticipated report to Congress on tax-exempt and public hospitals.

Go here to see the senators’ news release about their letter and the letter itself.…