For Fiscal Year 2018, the state of Indiana’s Medicaid budget was a whopping $11.8 billion. Despite its investment, Indiana struggles with its health outcomes: for example, it places 44th in the nation for adult smoking, and is 7th worst in the country for its rates of infant mortality. These statistics have plagued Indiana in recent years and were recognized as a detriment to the future growth of the state. Former governor Mitch Daniels started the Healthy Indiana Plan in 2008 as a tool to expand access to health insurance. The plan initially prioritized healthcare coverage for Hoosiers and this vehicle for health insurance has expanded over a decade from 40,000 enrolled to over 400,000 under the Affordable Care Act. Health and human services workers in the state, including Jennifer Sullivan, Secretary of Indiana’s Family and Social Services Administration, began to wonder whether the Healthy Indiana Plan could do more than just ensure healthcare coverage: could the “Plan” be a broader vision to lead to better health outcomes through preventative and wraparound care and connectivity to social services and the community? In other words, as opposed to only ensuring that Hoosiers had coverage after health catastrophes, could the Plan work to create a healthy state through preventing devastating health issues in the first place, and through making health (not just health care) a shared responsibility and goal?
At Leadership for a Networked World’s 2019 Health and Human Services Summit: Purpose, Passion and Impact for the Future, Sullivan shared how her office set a strategy to move upstream in value by focusing on social determinants of health, in other words, focusing on the environmental conditions and factors such as housing, nutrition, transportation, education, etc., that influence health and human services outcomes. This new initiative would put Hoosiers and their families at the center of its work.