How Revised Rules for Medicaid Managed Care Empower States to Address Patients’ Social Service Needs
<p>With its emphasis on coordinated care and prevention, managed care seems well geared to take on the “social determinants of health” – the range of nonmedical factors, from housing and food insecurity to drug addiction and domestic violence, that can affect health and health care costs. But Medicaid plans and providers were often discouraged in the past from assisting their clients with social service needs.</p><p>That started to change in 2016, when the Centers for Medicare and Medicaid Services (CMS) updated its regulations for Medicaid managed care plans. In the second of a series of Commonwealth Fund briefs, David Machledt with the National Health Law Program explores the potential impact of new provisions intended to support long-term services and supports provided in the home, reduce administrative barriers to population health investment, and incentivize plans to coordinate with community-based service providers.</p>
<p>“As Medicaid’s scope has grown, the ‘health care only’ model has become increasingly anachronistic,” the author says. Find out how the CMS changes can help change that paradigm, and what policymakers still must do to ensure the savings gained from social needs investment are shared equitably. </p>