Considerations for evaluating state Medicaid initiatives addressing health-related social needs

State Medicaid agencies are implementing initiatives to address members’ health-related social needs (HRSN) using a range of federal policy mechanisms, including managed care in lieu of services, section 1115 demonstrations, and home- and community-based services waivers, among other levers. Regardless of the mechanism, a robust approach to both implementation and impact evaluation is essential for understanding program outcomes and identifying opportunities for improvement.

This tool provides practical guidance for Medicaid agencies in developing effective strategies to monitor implementation and evaluate the impact of HRSN initiatives. It outlines federal requirements for HRSN program evaluation, highlights key elements to support effective monitoring, and shares considerations for developing evaluation plans. The tool draws from the experiences of states participating in the Medicaid Health-Related Social Needs Implementation Learning Series, a peer learning community coordinated by the Center for Health Care Strategies (CHCS) in partnership with HealthBegins and the Social Interventions Research and Evaluation Network.