Funder: The Commonwealth Fund
Author: Anna Spencer, Jim Lloyd, and Tricia McGinnis, Center for Health Care Strategies
December 2015 | Brief
Although 95 percent of the nation’s health care spending is for medical services, roughly 50 percent of preventable deaths are attributable to non-medical factors such as social circumstances, environmental issues, and individual behaviors. State policymakers increasingly recognize that addressing the social determinants of health is a critical component for both improving outcomes among Medicaid beneficiaries and reducing health care spending. A number of states are testing models that incorporate supportive services into their Medicaid state plans.
Massachusetts, New York, Oregon, Utah, and Vermont have all developed reimbursement strategies to pay for certain supportive services within their Medicaid programs. Building off previous work by the Center for Health Care Strategies (CHCS), this brief examines how these states are using Medicaid funding for supportive services as part of broader delivery system and payment reform efforts. CHCS conducted interviews with state officials, community providers, and national experts to identify how these Medicaid programs are determining the appropriate scope of supportive services and incorporating them into their state plans. Drawing from these interviews, this brief provides practical state case studies to help inform supportive service payment strategies within accountable care organizations, health homes, community health teams, accountable communities for health, and other value-based delivery system reforms.
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