Social determinants of health are the non-medical factors — such as where people live, work, and play — that influence individuals’ health. According to the World Health Organization, these factors can account for 30-55 percent of health outcomes. A recent Texas-specific study found that non-medical factors such as physical infrastructure (e.g., air quality, safe housing) and economic environment (e.g., income, education) influence health outcomes, as measured by standard Medicaid quality metrics.

Health care payers and providers in Texas and across the country have piloted non-medical interventions with notable effects on health care cost, quality, and experience of care. However, limitations around Medicaid managed care rate setting and payment can limit the growth of these efforts.

This report outlines how Texas could better support and sustain non-medical interventions and partnerships using In Lieu of Services authority, with a specific focus on three types of interventions: (1) asthma remediation; (2) Food is Medicine; and (3) services and supports designed to complement existing housing programs. The report includes evidence for each broad category of services, and specific populations that may benefit from these interventions — including children, pregnant women, and people experiencing serious mental illness.

Download the report at