Given the often overwhelming prevalence of social needs facing Medicaid populations, including housing, transportation, and nutrition, aligning social services and supports with health care delivery is critical. Many states recognize the connection between social determinants of health and health care utilization and outcomes, and are building the infrastructure to support social service delivery through accountable care organization (ACO) programs.

This brief, made possible through support from The Commonwealth Fund, highlights the initial efforts of seven states — Colorado, Maine, Minnesota, New York, Oregon, Vermont, and Washington — that participated in CHCS’ Medicaid ACO Learning Collaborative. These states each have sought to incorporate social services into their existing or emerging Medicaid ACO models. The brief outlines key themes and considerations from these early adopters to help additional states support collaboration between ACO and social service providers.