Want to Survive the Coronavirus Pandemic? Invest in the Social Determinants of Health

Michael Menconi
2020
Local, state, and federal governments are currently responding to the immediate healthcare infrastructure demands created by the COVID-19 crisis. In New York City, these responses have included erecting makeshift field hospitals in Central Park, converting the Javits Convention Center into a 1,000-bed field hospital, and sailing the 1,000-bed USNS Comfort to Pier 88 in Manhattan. Such unprecedented efforts have required assistance from the New York Army National Guard, the United States Army
more » ... ps of Engineers, and the U.S. Navy. Simultaneously, government-enacted social distancing measures have been implemented to "flatten the curve." The predominant consensus among experts is that the combined strategies of widespread social distancing and isolation in conjunction with unprecedented health infrastructure expansion is the only way to avoid reaching a crisis point within the U.S. healthcare system—a disastrous scenario in which hospitals become unable to manage the exponential influx of patients. The situation is most dire in New York City, as the number of confirmed COVID-19 cases approaches 165,000. In the background, however, an obscure evidence-based healthcare delivery program designed to serve New York's most vulnerable populations may be the most effective weapon in addressing resource shortfalls. In fact, this policy has the potential to mitigate the ongoing overflow of New York City's emergency rooms, intensive care units, and inpatient units, potentially saving countless lives while simultaneously streamlining the massive public health response. This policy is known as the Delivery System Reform Incentive Payment Program (DSRIP), which derives from the current New York State Medicaid expansion program. DSRIP—a groundbreaking and award-winning Medicaid redesign initiative—was implemented in 2015 after Governor Andrew Cuomo signed a deal with the federal government that allowed $8 billion federal Medicaid dollars to directly address the social determinants of health (SDH). One of the resulting initiatives [...]
doi:10.7916/vib.v6i.5829 fatcat:pv6ttagrhzgvhfufddqdyrvewu