Medicaid programs are increasingly considering how best to address the social factors, such as housing, healthy food and economic security, that can affect health and medical expenditures. Often referred to as social determinants of health, these factors drive as much as 80 percent of population health outcomes. With Medicaid programs looking to contain costs and pay for health outcomes—not simply the volume of healthcare services delivered—there is a growing focus on addressing these social factors in both Medicaid fee-for-service and managed care programs. While states historically have had some experience tackling such issues for specialized, high-need populations, they are now confronting whether, and how, Medicaid should address SDOH for a broader population of Medicaid enrollees in order to achieve better health outcomes.
In a new issue brief for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health explores the “next generation” practices that states are deploying to address social factors using Medicaid 1115 waivers and managed care contracts, as well as the specific steps states can take to implement these practices. The issue brief is based on an in-depth review of the Medicaid managed care contracts in 17 states and Medicaid 1115 provisions in six states. The next-generation practices discussed in this analysis include:
- Moving beyond screenings to systematic efforts to connect enrollees to social supports
- Expanding the scope of SDOH interventions to more populations and social issues
- Building a stronger network of community-based organizations and collaboration with providers
- Creating opportunities for affordable housing
- Aligning financial incentives to support SDOH interventions
- Employing systematic evaluation and expanding use of SDOH data
Read the full issue brief here. Read a short highlight of the brief here.
Support for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the foundation.