Studying the feasibility of reimbursing social and health care services in one billing system to better address the social determinants of health

The Foundation initiative, Systems for Action: Services and Systems Research to Build a Culture of Health, was designed to form the evidence base for the public health services and systems research (PHSSR) needed to build a Culture of Health, by: (1) supporting PHSSR focused on advancing a Culture of Health and real-world applications of that research; and (2) establishing satellite centers throughout the United States that will provide additional capacity to identify, develop, and oversee new and emerging areas of research within the field.This study evaluates a novel mechanism for integrating the delivery and financing systems of medical and social services by integrating health and social services billing codes. Addressing the social determinants of health is vital to improving individual and population health and advancing health equity. Although many approaches to dealing with disparities focus on social, rather than medical, services, research has indicated that integrating health and social services is both necessary and cost-effective. In fact, some states have worked to integrate social services into their Medicaid programs. Unfortunately, the current payment system for the reimbursement of social services lacks the ability to reimburse some nonmedical service providers, which creates barriers to addressing the social determinants of health and results in gaps between systems. This Columbia University study will explore the feasibility of expanding existing billing codes for social services, thereby allowing social and healthcare services to be reimbursed within one system. Using legal and policy analyses and informed by stakeholder engagement, the research team will develop and test the acceptability of expanding the current set of existing social service codes and explore alternative options. Developing a coding and reimbursement system that facilitates access to social services through medical systems would increase the likelihood that important services could be covered by insurers and begins addressing the call for health in all policies.