5 Ways CMS Can Better Address Social Determinants of Health in Medicaid

Richman E
Publication Year: 2018
Population Focus: Medicaid beneficiaries
Type of Literature: Grey


Insights Results

Overview of article

  • Based on reviews of Medicaid managed care contracts in 40 states, along with 25 approved 1115 demonstrations, there are several ways federal law can be more flexible when it comes to these types of services that are listed below
  • Make it easier for vulnerable populations to access health services and care coordination: By suggesting modifications to 1115 demonstrations, CMS can help make sure this information from demonstrations is front and center to reduce churn in vulnerable populations
  • Enhance agency collaboration at the federal level: Currently, interagency coordination on social determinants of health isn’t especially common
  • Provide additional guidance on how states can encourage and incent MCOs to invest in social determinants, including information on how plans are allowed to use “in lieu of” and “value added” services to improve interventions on social determinants
  • Approve section 1115 demonstrations that test strategies to address social determinants
  • Support outcomes-based payment for social determinants interventions so they are being used on proven and successful models for interventions