Incorporating community-based organizations in Medicaid efforts to address health-related social needs: Key state considerations

State Medicaid programs are increasingly connecting the dots between the medical, behavioral, and social components of health to achieve the goal of more equitable, whole-person care that addresses the health-related social needs (HRSN) of Medicaid enrollees. Developing HRSN interventions that are locally focused, culturally congruent, and community-centered requires partnerships with community-based organizations (CBOs) that specialize in social care, like food and housing services.

Both state and federal agencies have encouraged more integration of CBOs into the traditional health care landscape. Medicaid agencies increasingly require health care organizations (HCOs) — like managed care organizations, accountable care organizations, and providers — to partner with CBOs. New guidance from the Centers for Medicare & Medicaid Services on HRSN services will likely expand the impact of these relationships.

This Center for Health Care Strategies report, made possible by the California Health Care Foundation, explores insights from early state innovators to help guide states, HCOs, and CBOs in shaping and navigating successful CBO-HCO relationships. The report draws from an examination of leading-edge state Medicaid programs requiring formal CBO-HCO partnerships, as well as stakeholder and expert interviews, to identify best practices and implementation considerations for other states interested in strengthening CBO-HCO partnerships.