Financing approaches to address social determinants of health via Medicaid managed care: A 12-state review

Over the last decade, Medicaid managed care organizations (MCOs) have invested in local communities and developed programs to better address the individual-level health-related social needs (HRSN) of their enrollees. While most states use their MCO contracts to encourage approaches for identifying and addressing HRSN, states use varying strategies to finance HRSN activities, and sustainable funding streams for these efforts are not always available.

With support from the Association for Community Affiliated Plans (ACAP), the Center for Health Care Strategies reviewed how 12 states are financing MCO HRSN activities and using federal flexibilities to do so. This report outlines common themes across state financing approaches and includes examples of state activities to inform state and MCO efforts across the nation. The report also details considerations for federal agencies and policymakers to guide future efforts to bridge the worlds of health care and social care.