Cash Benchmarking For Integrated Health Care And Human Services Interventions: Finding The Value Added

Abstract

Health-related social needs, which include food insecurity, housing instability, and lack of transportation, are strongly associated with poor health outcomes, more health care use, and higher health care spending. Integrating human services that address health-related social needs into health care may address these issues. In this article we propose an innovative methodological approach (borrowed from developmental economics) called cash benchmarking, which can help determine when health care and human services integration is most useful. This is important because while integrating human services into health care offers potential benefits, it also comes with potential downsides-including the medicalization of social needs; deemphasis of upstream societal causes of health-related social needs, such as tax policy and labor conditions; and opportunity costs within the health care system, as resources are shifted to delivering social care. Ultimately, cash benchmarking can help stakeholders navigate closer to the promise, and away from the pitfalls, of health care and human services integration.

Association of a Fruit and Vegetable Subsidy Program With Food Purchases by Individuals With Low Income in the US

“…Additional studies should explore these issues, potentially by using cash-benchmarked study designs that can isolate the impact of clinic-based approaches from the cash value of the benefit offered. 43 …”

“…Reasons the results may not be generalizable include the characteristics of those enrolled and the setting of clinic-based enrollment, which may have worked synergistically with the cash value of the benefit provided to influence purchases of healthy food. Additional studies should explore these issues, potentially by using cash-benchmarked study designs that can isolate the impact of clinic-based approaches from the cash value of the benefit offered …”

Implementation of NCCARE360, a Digital Statewide Closed-Loop Referral Platform to Improve Health and Social Care Coordination: Evidence from the North Carolina COVID-19 Support Services Program

“…An unintended consequence could be prioritizing health care-related system-based solutions as opposed to more effective, equitable, and efficient strategies or policy levers to address social needs (e.g., tax, labor, or social welfare policies). If social care interventions are prioritized based on their potential to reduce health care costs, this could lead to a myopic focus on current high utilizers and have the unintended consequence of expanding existing disparities [48].…”

Prescription for Cash? Cash Support to Low‐Income Families in Maternal and Pediatric Health Care Settings

“…Although cash transfers have tremendous potential for impact in maternal and pediatric settings, including as a way of benchmarking the effectiveness of programs that provide connection to referral services, 102 there are several barriers to their implementation. First, Medicaid is limited by law in its ability to use funds on nonhealth expenditures.…”