The Center for Community Engagement in Health Innovation and The SNP Alliance Jointly produced Special Needs Plans: Focusing on Social Determinants of Health among Duals.

This report examines how two special needs health plans are responding to the social determinant of health characteristics to improve health outcomes for people who are dually eligible for Medicare and Medicaid.

The SNP Alliance and the Center share a mutual interest in focusing attention on important policy, practice and social issues impacting the dually eligible beneficiary population.

Social determinants of health ― also known as social risk factors ― can significantly impact medical and health outcomes. Individuals who are dually eligible (low-income meeting Medicaid criteria, and disabled or elderly meeting Medicare criteria) often have more social risk factors than the general population. Factors include: income/poverty status, housing instability, education level, limited English proficiency, partnership status, and transportation difficulties.

Many of the health-related needs of dually eligible individuals require non-medical supports, so addressing these risk factors requires collaborative efforts with partners within each community to ensure solutions that are locally designed and implemented. These partnerships can extend across services, settings and systems, among organizations that serve the same people within a geographic region.

The report provides two case studies, highlighting the efforts of Care Wisconsin and UPMC Health Plan to collaborate with providers and communities to address the social determinants of health affecting their enrolled members.