Social determinants of health— Medicaid coverage and payment

Recent guidance from the Centers for Medicare and Medicaid Services (CMS) provides new clarity on Medicaid and SCHIP authority for reimbursement of SDOH screening and interventions in particular circumstances. This publication demonstrates opportunities to use SDOH screening tools such as PRAPARE to improve the delivery of care through enhanced data collection and relationships with safety-net programs.

Screening for and addressing social determinants of health (SDOH) are widely recognized as essential for delivering whole person care, improving health equity, lowering total costs of care, and participating in value-based care. Current events underscore the critical importance of addressing SDOH, with populations served by Health Center Program grantees and look-alikes being disproportionately impacted by COVID-19. The health center model of care uniquely positions health centers to play active roles in integrating SDOH services and aligning with community-based organizations. Furthermore, health centers are committed to improving health equity. Recent guidance from the Centers for Medicare and Medicaid Services (CMS) provides new clarity on Medicaid and SCHIP authority for reimbursement of SDOH screening and interventions in particular circumstances. This publication demonstrates opportunities to use SDOH screening tools such as PRAPARE to improve the delivery of care through enhanced data collection and relationships with safety-net programs.