With increasing support and guidance from the Centers for Medicare & Medicaid Services (CMS) and its federal partners, states are using a variety of Medicaid levers to address individuals’ health-related social needs (HRSN). This is still a new and emerging priority for many state Medicaid programs and there is no one-size fits all approach to offering HRSN services to members. State policymakers will need to determine how to most effectively implement HRSN service coverage based on their specific state context.

This tool presents foundational decision points for states in defining an approach to address HRSN, with a focus on three key areas: (1) coverage; (2) accountability mechanisms; and (3) infrastructure to support partnerships with community-based organizations (CBOs) to provide HRSN services. It also features practical examples detailing how nine states — California, Massachusetts, Michigan, New York, North Carolina, Oregon, Pennsylvania, Washington, and Wisconsin — are approaching decisions related to HRSN services. The featured states are participants in the Medicaid Health-Related Social Needs Implementation Learning Series, a peer learning community coordinated by the Center for Health Care Strategies (CHCS) in partnership with HealthBegins and the Social Interventions Research and Evaluation Network, through support from the Kaiser Permanente National Community Benefit Fund at The East Bay Community Foundation.