Medicaid plays an essential role in the U.S. health care system, providing health coverage for millions of individuals in the United States. People’s health and well-being, however, are influenced by many factors outside of medical care and services, including where individuals live and work. Health and well-being are also impacted by race, socioeconomic status, educational attainment, gender identity, sexual orientation, and ability. Given the multiple factors that impact health, cross-agency and cross-sector partnerships among health care and non-health sectors are critical to advance equitable programs and policies in population health.

The Center for Health Care Strategies (CHCS), through support from the Robert Wood Johnson Foundation, pursued innovations to advance population health efforts that better meet the health and social needs of people served by Medicaid. Building on lessons for effective Medicaid-public health partnerships that CHCS distilled through the CDC’s 6|18 Initiative, this two-prong project focused on collaborative opportunities for Medicaid, public health, and public sector partners to: (1) advance health equity; and (2) address food insecurity.

Cross-Agency Partnerships for Equity

Cross-agency partnerships between state Medicaid and public health programs have great potential to advance health equity for the communities they serve, especially people from communities of color who have experienced enduring health inequities because of systemic racism and disproportionate physical, social, and economic impacts. Medicaid and public health programs are well-positioned to advance health equity by collaborating on shared equity goals to reduce health disparities for communities of color. CHCS explored opportunities to promote health equity at the state level through cross-agency partnerships. The project aimed to identify:

• Shared health equity priorities that state agencies have the capacity to advance;
• Practical strategies for partnerships to achieve shared health equity goals; and
• Opportunities to involve community and enrollee voices as part of these efforts.

Exploring Cross-Agency Partnerships to Address Food Insecurity

Consistent access to fresh, affordable, nutritious food is a significant challenge for many Medicaid members. Moreover, Black and Latino households with children are nearly twice as likely to be struggling with food as similar white families. State agencies, including Medicaid and social service agencies, increasingly recognize the value and importance of centering individual and community voices in the policymaking process, especially those from communities of color who experience disparities in food security. The significant overlap in eligibility for Medicaid and food support programs, such as SNAP, provides opportunities for states to coordinate their policies and processes to improve administration, customer service, partnerships, and program participation.

CHCS explored partnership opportunities among state entities administering SNAP, WIC, and Medicaid to address food insecurity for Medicaid enrollees by connecting state partners and centering lived expertise. An advisory group, comprised of individuals and organizations with policy, program, and lived expertise, provided guidance to CHCS. The project aimed to:

• Explore opportunities to align across sectors to decrease food insecurity and improve health for Medicaid enrollees;
• Understand Medicaid, SNAP, and WIC enrollees’ perspectives and ideas about strategies to dismantle systemic and structural barriers to food security; and
• Uncover how such opportunities intersect with state agency priorities, as well as the key barriers confronting such efforts.

Spreading Lessons

CHCS distilled and disseminated lessons for promising cross-sector partnership efforts and opportunities to advance equity and address food insecurity, which can be found below.