Delivering Value with Medicaid Managed Care

Munson K
Publication Year: 2019
Patient Need Addressed: Financial insecurity, Food insecurity, Homelessness/housing, Patient satisfaction/engagement, Transportation
Population Focus: Medicaid beneficiaries
Intervention Type: Staff design and care management
Type of Literature: Grey


Insights Results

Overview of article

  • When it comes to serving low-income, vulnerable populations, MCOs must go beyond just providing access to needed medical, behavioral and pharmacy care. It’s estimated medical care accounts for only 10% to 20% of health outcomes. The rest can be attributed to “social determinants of health” like where you live, what you eat, how secure you feel, and how connected you are to those around you
  • One way MCOs are making healthcare more accessible and effective for Medicaid members is by personalizing the care management system. At WellCare, for example, care managers engage with certain members face-to-face, meeting them where they live to gain a fuller understanding of their health and life circumstances

Key takeaways/implications

  • Medicaid MCOs are on the frontlines addressing social determinants of health. In response, MCOs are creating solutions that help members receive the social services they need to remove barriers to good health (e.g., WellCare’s Community Connections Help Line, a toll-free line that connects both members and non-members to local, community-based resources that offer services such as food, transportation, housing, education, and utilities assistance)