State Medicaid agencies are seeking to address member health-related social needs (HRSN) and, in 2021, CMS issued state guidance on ways to finance select nutrition and housing supports using Section 1115 demonstrations and managed care in lieu of services; developed quality measures that encourage social needs screening; and proposed updated managed care rules with a focus on access and quality.
This policy window provided unique opportunities for states to advance HRSN strategies within Medicaid and promote health equity for communities that have been historically marginalized. To help states develop effective approaches to address HRSN, the Center for Health Care Strategies (CHCS), with support from Kaiser Permanente through its National Community Benefit Fund at The East Bay Community Foundation, led the Medicaid Health-Related Social Needs Implementation Learning Series. In partnership with HealthBegins and the Social Interventions Research and Evaluation Network (SIREN), CHCS worked with nine states — California, Massachusetts, Michigan, New York, North Carolina, Oregon, Pennsylvania, Washington State, and Wisconsin — to develop, implement, or refine HRSN initiatives for Medicaid populations.
The 12-month learning series helped these states:
- Strengthen HRSN strategies and programs, with an eye toward effective, on-the-ground implementation by Medicaid managed care organizations, health care systems, and community-based organizations (CBOs);
- Translate emerging best practices and evidence; and
- Promote health equity and center community member voice.
Participating states engaged in peer-to-peer information sharing and learning opportunities to advance their HRSN policy and implementation goals. The curriculum enabled states to shape HRSN policy approaches with a focus on: (1) supporting health care organization and CBO partnerships; (2) developing accountability mechanisms, including process and outcome measures for HRSN work; and (3) creating Medicaid benefits based on existing or emerging evidence.
Throughout the 12-month initiative, a broad array of resources were developed to support policy formation and implementation efforts related to addressing HRSN. Tools, webinars, and case studies distilling lessons and emerging insights gleaned from the learning series can be found below.
