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COVID-19 and social determinants of health: Medicaid managed care organizations' experiences with addressing member social needs

S.T. Opoku, B.A. Apenteng, L. Kimsey, A. Peden, C. Owens
PLoS One

Background: The significant adverse social and economic impact of the COVID-19 pandemic has cast broader light on the importance of addressing social determinants of health (SDOH). Medicaid Managed Care Organizations (MMCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid members. However, the experiences of MMCOs in addressing member social needs during the pandemic has not yet been examined. AIM: The purpose of this study was to describe MMCOs' experiences with addressing the social needs of Medicaid members during the COVID-19 pandemic. Methods: The study was a qualitative study using data from 28 semi-structured interviews with representatives from 14 MMCOs, including state-specific markets of eight national and regional managed care organizations. Data were analyzed using thematic analysis. Results: Four themes emerged: the impact of the pandemic, SDOH response efforts, an expanding definition of SDOH, and managed care beyond COVID-19. Specifically, participants discussed the impact of the pandemic on enrollees, communities, and healthcare delivery, and detailed their evolving efforts to address member nonmedical needs during the pandemic. They reported an increased demand for social services coupled with a significant retraction of community social service resources. To address these emerging social service gaps, participants described mounting a prompt and adaptable response that was facilitated by strong existing relationships with community partners. Conclusion: Among MMCOs, the COVID-19 pandemic has emphasized the importance of addressing member social needs, and the need for broader consideration of what constitutes SDOH from a healthcare delivery standpoint.

Opoku ST, Apenteng BA, Kimsey L, Peden A, Owens C. COVID-19 and social determinants of health: Medicaid managed care organizations' experiences with addressing member social needs. PLoS One. 2022;17(3):e0264940. Published 2022 Mar 10. doi:10.1371/journal.pone.0264940 PMID: 35271632 PMCID: PMC8912251

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Publication year
Resource type
Peer Reviewed Research
Outcomes
Process
Provider Experience of Care
Population
Medicaid-insured
Social Determinant of Health
Not Specified
Study design
Other Study Design