Marrying value-based payment and the social determinants of health through Medicaid ACOs: Implications for policy and practice

State Medicaid programs are experimenting with two vital trends in health policy—value-based payment (VBP) and interventions intended to address social determinants of health (SDOH). We analyzed the policy levers employed by states through their Medicaid accountable care organizations (ACOs) to incorporate requirements and incentives for ACO providers to address SDOH. The policy approaches fall into three main categories: (1) requirements that providers screen for social risks; (2) requirements or incentives for partnering with social service organizations; and (3) requirements or incentives for SDOH-associated quality metrics.