This project seeks to translate important considerations in bioethics into policy outcomes for Medicaid programs investing in supports that address social determinants of health, also known as health-related social needs (HRSNs). The team aims to ensure that policymakers take bioethical principles on resource distribution and the valuing of outcomes beyond financial impacts prioritized by health care institutions into consideration when planning the expansion of an HRSNs pilot in Massachusetts’s Medicaid program. This project will be led by Health Care For All (HCFA) Massachusetts, a consumer advocacy organization, that works with bioethical researchers, the state’s Medicaid leadership, and social service organizations across the state.
Our Grants
Improving Bioethics in SDOH-Focused Medicaid Programs
Alex Sheff, MPA
Health Care For All
Health Care For All
Grant Type
Bridging Bioethics Research & Policymaking
Grant Cycle
2024
Duration
12 months
Amount
$46,551
Grantee Q&A
We ask Bridging Bioethics Research & Policymaking grantees about lessons learned for increasing bioethics’ impact on policymaking.
Who was the intended audience for your project?
Our team worked to translate bioethical principles into concrete policy outcomes in the new Medicaid health-related social needs (HRSN) program in Massachusetts, known as MassHealth. The audience for the project included policy makers in Massachusetts such as program leaders at MassHealth, as well as those working in Medicaid agencies around the country on similar efforts. The audience also included leaders at health systems participating in the HRSN program and social service organizations (SSOs).
What message did you seek to deliver and how?
We sought to: (1) advance a more equitable distribution of resources across SSOs, including smaller organizations with local community knowledge, and (2) broaden the definition of success for the HRSN program beyond traditional notions of return on investment during the program’s transition from being grant-based to billable service-based. The project required articulating how program design choices could support these goals. Focus also later shifted to highlighting the value of the HRSN program model in the face of funding constraints and other challenges.
How did you involve collaborators outside of bioethics research in your project?
Our team at Health Care for All worked with the Social Services Integration Working Group at MassHealth to provide feedback on program options during the transition to the new billable service-based model. We engaged with members of the Alliance for Community Health Integration to incorporate a wider range of public health and SSO perspectives to our work with MassHealth. Importantly, we also collaborated with Lauren Taylor, PhD, a bioethicist at the NYU Grossman School of Medicine, to ensure recommendations were evidence-based and reflected the ethical principles articulated in the bioethics literature.
What lessons did you learn about translating bioethics research to policymaking?
We learned to be adaptable through this project, which required adjusting to new federal leadership and a significantly different political and policy environment than when the project was conceived. Despite having to adjust our approach, we still saw positive outcomes on our proposed metrics of success, which we attribute largely to focusing on the overarching goals of the work, even as the details of the strategies had to change. We would advise future teams seeking to translate bioethics research to take a similar approach, focusing on broad goals and allowing strategies to follow from that orientation.
Grant Focus Areas
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