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Medicaid and Social Needs (February 2020)

Do State-Based Interventions Decrease Medicaid Expenditures and Improve Enrollee Well-Being?

By Sydney McClendon, Phillip Steiner, M.A. | February 20, 2020

Medicaid and Social Needs (February 2020)


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Many state Medicaid agencies and managed care organizations (MCO) are seeking to improve health outcomes and reduce per person health care spending through interventions that address social needs faced by enrollees. In implementing these interventions, states and MCOs are recognizing that many factors beyond medical care contribute to health outcomes, including social circumstances and environment.

How are KanCare MCOs addressing social needs? What is being done in other states? What challenges do Medicaid programs face when implementing interventions? Find the answers to these questions and more in our latest brief, which explores a subset of policy interventions driven by state Medicaid agencies and Medicaid MCOs.

Key points from the brief include:

  • Early evidence suggests that interventions targeting social needs can decrease Medicaid expenditures while improving enrollee well-being, but more research is needed.
  • States are using a mix of state plan amendments, value-based payment strategies and demonstration waiver authority to address social needs among their Medicaid enrollees.
  • Medicaid directors and Medicaid managed care organizations cite housing issues as one of the top social needs of enrollees.
  • Medicaid programs and managed care organizations implementing interventions face challenges when addressing social needs, including inadequate reimbursement structures, limited expertise and capacity within the health care sector and needed culture changes within their own organizations.

*List of reference materials used in this analysis.

The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.