With the release of the New York State Health Equity Reform (NYSHER) 1115 Medicaid Waiver, there have been a slew of new acronyms and terms to get used to. One of them is Health-Related Social Needs (HRSN). What are they? And what is the difference between SDOH and HRSN?
Social Determinants or “Drivers” of Health (SDOH) are community-level factors such as environmental conditions which can affect health outcomes. A SDOH screening reveals these conditions and their correlative impact on a person’s health, functioning, and quality-of-life outcomes and risks.
Health Related Social Needs (HRSNs) refer to drivers of health outcomes which directly impact health inequalities, including but not limited to nutrition, housing, and transportation. According to CMS, specifically, “HRSN refers to individual-level factors such as financial instability, lack of access to healthy food, lack of access to affordable and stable housing and utilities, lack of access to health care, and lack of access to transportation.
Under the NYHER 1115 Waiver Amendment some HRSN services will be reimbursable. For the purpose of this waiver, an HRSN service is limited to services that are NYHER-financed as approved by the Federal Government. According to New York State, the “SCN program presents an unprecedented opportunity to address health-related social needs and to advance health equity via the Medicaid program across New York State”.
In the example above, if the Medicaid Member meets criteria as outlined by New York State guidance, they may be able to receive asthma remediation services through Medicaid to purchase a air conditioner that will help alleviate some of their asthma symptoms during the summertime.