Why Medicaid is the Platform Best Suited for Addressing Both healthcare and Social Needs

Witgert K
Publication Year: 2017
Patient Need Addressed: Care Coordination/Management, Financial insecurity, Food insecurity, Homelessness/housing, Transportation, Trauma
Population Focus: Medicaid beneficiaries
Intervention Type: Service redesign, Staff design and care management
Type of Literature: Grey


Insights Results

Overview of article

  • This article describes how Medicaid programs can serve as a platform to address health and social needs of its beneficiaries. It also provides current examples of Medicaid programs working to integrate social services into such programs

Key takeaways/implications

  • Current examples of Medicaid programs connecting patients to social services include: 1) In Pennsylvania, the online health and human services programs eligibility system known as COMPASS allows individuals and families to simultaneously apply for Medicaid, the Children’s Health Insurance Program (CHIP), and the health insurance marketplace, together with programs that administer food stamps, school lunches, child care assistance, and other benefits; 2) Colorado’s Medicaid program divides the state into 7 Regional Care Collaborative Organizations, each of which connects beneficiaries to healthcare providers as well as social and community services to link patients with a primary care provider who not only serves as a central point of contact for medical care, but also assesses a person’s non-medical needs; 3) Louisiana has embedded permanent supportive housing into Medicaid home- and community-based services, allowing for better integrated care for individuals who are homeless or at risk of homelessness; 4) Oregon began aligning its healthcare and early education systems around 2011. The Medicaid program and early learning systems share goals, staffing, and funding; 5) Massachusetts, New York, Oregon, Utah, and Vermont are all testing strategies not only to link Medicaid and social services, but also to use Medicaid funds to actually deliver supportive services that affect social determinants of health
  • Most recently, the Centers for Medicare and Medicaid Services (CMS) launched an initiative called Accountable Health Communities to better manage the health-related social needs of Medicare and Medicaid enrollees. The initiative will test whether systematically identifying and addressing the social determinants of health through screening, referral, and community navigation services will impact healthcare costs and reduce healthcare utilization. Over the next 5 years, the model will provide support to community organizations that link enrollees to services that address housing instability, food insecurity, utility needs, interpersonal violence, and transportation needs
  • Medicaid is well positioned to integrate healthcare and social services for 3 reasons: 1) Medicaid is present in all 50 states; 2) Medicaid is a federal-state partnership and can be tailored to state-specific needs; 3) Medicaid is large and impacts a large population and 4) Medicaid programs already have experience serving diverse populations who may benefit from a range of social services