Publications

This article reviews Oregon’s efforts to improve outcomes and reduce costs within their Medicaid program through health-related social needs.

This report focuses on the care coordination functions that support the interventions and services within a whole-child approach to children’s health care.

This report describes parents’ experiences with their children’s Medi-Cal coverage and their recommendations for improving children’s health care, as well as how health plans can collaborate with families on systems change.

This report examines Medi-Cal managed care as a tool to advance child health equity, and it looks at the extent to which managed care plans can play a central role in Medi-Cal responding to social drivers of health and health-related social needs, particularly for children’s health.

Despite a need for financing reforms that better incentivize addressing patient whole health and wellness, the lack of clear standardization of social determinants of health screening tools, interoperable data collection systems, lack of robust health-related social services expenditure data, and financing uncertainties and insecurities present significant challenges for value-based payment arrangements, according to this analysis.

At this early stage of social determinant of health incorporation, many states are targeting their programming, particularly screening and care management/coordination, towards high-risk populations, such as beneficiaries in substance use disorder treatment or those with significant behavioral health needs, children with complex care needs, beneficiaries living with HIV, and individuals with multiple comorbidities.

By promoting use of health-related services and adding a profit reinvestment mandate, Oregon is using managed care contracting to expand Medicaid spending on social determinants of health and health equity.

Lessons learned and promising practices shared by participants fell under four themes: member-centeredness, community-centeredness, structured yet adaptable social determinants of health programming, and realigning systems for whole-person care.

Among Medicaid Managed Care Organizations, the COVID-19 pandemic has emphasized the importance of addressing member social needs, and the need for broader consideration of what constitutes social determinants of health from a health care delivery standpoint.

This article highlights the new RWJF Community Research for Health Equity grant awarded to Arizona State University.