State Medicaid agencies are increasingly seeking to address member health-related social needs (HRSN). The Centers for Medicare & Medicaid Services (CMS) is encouraging state Medicaid programs to integrate HRSN strategies using a range of policy levers, with an explicit focus on health equity. CMS recently issued state guidance on ways to finance select nutrition and housing supports using Section 1115 demonstrations and 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 current policy window provides 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, is leading the Medicaid Health-Related Social Needs Implementation Learning Series. In partnership with HealthBegins and the Social Interventions Research and Evaluation Network (SIREN), CHCS is working 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 is helping 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 are engaging in peer-to-peer information sharing and learning opportunities to advance their HRSN policy and implementation goals. The curriculum is enabling 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 designed to support policy formation and implementation efforts related to addressing HRSN will be shared publicly. Tools, webinars, and case studies distilling lessons and emerging insights gleaned from the Learning Series will be shared nationally for those interested in advancing HRSN for Medicaid enrollees and advancing health equity.