Opportunity to comment on proposed removal of health equity and social drivers of health quality measures in Medicare inpatient programs

Among many many other distressing actions, the Trump administration has begun rolling back CMS’ support for social risk interventions, including by rescinding Biden-era guidance on using Medicaid and CHIP to address health-related social needs, and limiting federal funding for some state Medicaid initiatives that support services beyond medical care as part of Section 1115(a) demonstrations. Most recently, CMS has proposed to eliminate the health equity commitment and social drivers of health quality measures that had been added in the past few years for inpatient care. Contrary to the other two changes, there is an opportunity to comment on these proposed eliminations. Read the proposed changes in inpatient care, long-term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and skilled nursing facilities. Comments can be submitted here until June 10th.

Registration is open for upcoming SIREN webinar: Unpacking the third AHC evaluation report

In November 2024, the Center for Medicare and Medicaid Innovation (CMMI) released the third evaluation report of the Accountable Health Communities (AHC) Model, in which Medicare and Medicaid beneficiaries in 28 communities were screened for social risks and offered navigation to help resolve identified risks. The 177-page report is chock-full of interesting findings. Join us for a webinar on May 8th 11am-12pm PST/2-3pm EST to unpack the report’s findings with Dawn Alley, former director of the AHC Model at CMMI and Head of Scale at IMPaCT Care and SIREN Co-Directors Caroline Fichtenberg and Danielle Hessler-Jones. 

HSR Special Issue: Learning from the SIREN 2025 National Research Meeting

This special issue showcases research abstracts presented at the SIREN 2025 National Research Meeting. The event included patients, researchers, educators, practitioners, community activists, policymakers, and funders, all hoping to advance health equity at the intersection of health and social care delivery. We very much hope that the conference abstracts—and the conference plenary presentations available on the SIREN website—can provide an inspirational package in this time of uncertainty and upheaval.

New: SIREN Anti-Racism Recommendations for Social Care Research

In case you missed our email last week, we have released a new section of our website focused on recommendations for applying four key principles of anti-racism praxis to each stage of social care research. The recommendations were developed through a three-year project. They reflect a synthesis of existing evidence and consultations with experts with decades of expertise in anti-racist and social care practice and scholarship. We hope the recommendations will be useful for you, too. We are indebted to the Robert Wood Johnson Foundation for supporting this project.  

Systems for Action: 2025 Call for Proposals: Community-Led Systems Research to Address Systemic Racism
This funding opportunity will provide up to $200,000 for one-year community-led feasibility studies of new interventions designed to dismantle and disrupt forms of systemic racism through the alignment of medical, social, and public health systems. Proposals are due on Wednesday, June 4, 2025, at 3pm ET. Click here for more details.

Addressing Violence and Trauma Topical PCORI Funding Announcement
The Patient-Centered Outcomes Research Institute (PCORI) issued a Topical PCORI Funding Announcement (PFA) on April 1, 2025, seeking to fund high-quality, patient-centered comparative clinical effectiveness research (CER) projects that focus on addressing violence and trauma.  Letters of Intent are due on Tuesday, May 13, 2025 at 5pm ET. Click here for more details.

Webinars

Center for Health Care Strategies: Building Community Care Hubs to Address Health-Related Social Needs: Lessons from New York and North Carolina Medicaid – April 30, 2025 | 10-11am PT/ 1-2pm ET

SIREN: Unpacking the Third AHC Evaluation Report – May 8, 2025 | 11am-12pm PT/ 2-3pm ET

Meetings & Conferences

Centers for Medicare & Medicaid Services: CMS Health Equity Conference – April 23-24, 2025 | Bethesda, MD & virtual

American Hospital Association: Accelerating Health Equity Conference – May 19-22, 2025 | Baltimore, MD

AcademyHealth 2025 Annual Research Meeting – June 7-10, 2025 |  Minneapolis, MN |

Camden Coalition: Putting Care At the Center Annual Conference – October 15-17, 2025 | Portland OR | Applications for Beehive stations are open until May 7, 2025.

Health Affairs: Theme Issue Briefing: Food, Nutrition & Health – Originally broadcast April 8, 2025

Below we share multiple SIREN-relevant articles published since the last newsletter. For a full list, see the SIREN Evidence and Resource Library. As always, if you are aware of resources that you think should be added to the library, please send them our way.

Peer-Reviewed Articles

Awareness 

LiFTS: Equitably Implementing a Social Needs Screening Program Bouchelle Z, Luke M, Menko SG, et al. | Hospital Pediatrics

Health-Related Social Needs Discussions in Primary Care Encounters in Safety-Net Clinics: A Qualitative Analysis De Leon E, Panganamamula S, Schoenthaler A | JAMA Network Open

Screening for Comprehensive Social Needs in Patients with Cancer: A Narrative Review Arana I, Liu R, Kushi L, Hahn E, Ragavan M | JNCI Cancer Spectrum

Leveraging Artificial Intelligence to Inform Care Coordination by Identifying and Intervening in Patients' Unmet Social Needs: A Scoping Review Davis VH, Pinto AD, Patel MR | Journal of Advanced Nursing

Development of a Natural Language Processing Algorithm to Extract Social Determinants of Health from Clinician Notes Zaribafzadeh H, Henson JB, Chan NW, et al. | American Journal of Transplantation

Interoperability of Health-Related Social Needs Data at US Hospitals Sandhu S, Liu M, Gottlieb LM, Holmgren AJ, Rotenstein LS, Pantell MS | Journal of the American Medical Informatics Association

Assistance

Assessing Equitable Implementation of a Social Care Initiative Integrating Medical and Social Services for Medicaid Members Safaeinili N, Chuang E, Hernandez E, et al. | Health Services Research

Health, Housing, and Justice: Two-Year Implementation Evaluation of a Health System's Multi-State Medical-Legal Partnership to Address Housing Instability Arora N, Terry S, Stevens HR, et al. | Health Services Research

Comparison of Clinic-Based Assistance Versus a Centralized Call Center on Patient-Reported Social Needs: Findings from a Randomized Pilot Social Health Integration Program Mahmud A, Brown MC, Wong ES, et al. | BMC Public Health

Hospital-Based Interventions Addressing Social Needs: A Systematic Narrative Review Neadley KE, Shoubridge C, Lynch JW, Boyd MA, Poirier BF | American Journal of Preventive Medicine

Feasibility of Deploying Community Health Workers to Assist with Health-Related Social Needs and Hypertension in Community Care Clinics Robusto B, Cheng I, Mahabaleshwarkar R, et al. | Journal of Clinical and Translational Science

Screening and Referral for Health-Related Social Needs and Financial Distress: Current Processes Among National Cancer Institute Community Oncology Research Program Practices Banegas MP, Nightingale CL, Dressler EV, et al. | JCO Oncology Practice

Food interventions

Health Impacts of Health System Implementation of a Food-As-Medicine Strategy Ronis SD, Hartman H, Neeland IJ, Leach A, Cunanan C | American Journal of Managed Care

Understanding the Reasons Why Patients with Food Insecurity Decline Social Assistance at a Large Academic Medical Center Connelley A, Young A, Lee JT, et al. | AJPM Focus

Health Affairs: Food, Nutrition & Health Special Issue

Medicaid Nutrition Supports Associated with Reductions in Hospitalizations and ED Visits in Massachusetts, 2020-23 Hager K, Sabatino M, Williams J, et al. | Health Affairs

Estimated Impact of Medically Tailored Meals on Health Care Use and Expenditures in 50 US States Deng S, Hager K, Wang L, et al. | Health Affairs

Food is Medicine in the US: A National Survey of Public Perceptions of Care, Practices, and Policies Ridberg R, Sharib JR, Garfield K, Hanson E, Mozaffarian D | Health Affairs

A New Approach to Guide Research and Policy at the Intersection of Income, Food, Nutrition, and Health Berkowitz SA, Seligman HK, Mozaffarian D | Health Affairs

Food For Thought: A Vision for Generative ‘Food Is Medicine’ Lumpkin JR, Davis M, Stewart V | Health Affairs

Food is More Than Just Medicine Bank A | Health Affairs

Modeling the Value of ‘Food Is Medicine’: Challenges and Opportunities for Scaling Up Medically Tailored Meals Palar K, Cox C | Health Affairs

Adjustment

“The Start of Something That I Hope Could Be Greater”: Health Information Technology Tools for Social Care Bunce A, Morrissey S, Gold R, et al. | SSM - Qualitative Research in Health

Applying Realist Retroduction to EHR-Based Clinical Decision Support Tool Development Morrissey S, Bunce A, Donovan J, et al. | International Journal of Qualitative Methods

Tools & Toolkits

CMS Accountable Health Communities Model: Practitioner's Implementation Guide Bollo O, Sheward R, Plata-Nino G | Hunger Vital Sign™ National Community of Practice

Commentaries & Blogs

Learning From the SIREN 2025 National Research Meeting Gottlieb LM, Angove R, Cartier Y, et al. | Health Services Research

Access to Care: The Role of Hospital-Based Violence Intervention Programs Arientyl V, Castater C, Hart L, Smith RN | The American Surgeon

Food Insecurity, Health, and Health Care in the US Ostrer IR, Seligman HK | JAMA

Navigating the Complexity of Food Insecurity Screening Coker T, Silverstein M, Barry MJ, Nicholson W | JAMA

The United States is Facing Unprecedented Challenges in the Field of Health and Health Care: What Can and Should We Do About it? A Call to Action The Late Career Health Scientist Group | Annals of Behavioral Medicine

Behind the Assault on Diversity, Equity, and Inclusion Woolf S | Milbank Quarterly Opinion.