The past decade brought a rapid growth in interest by state Medicaid leaders in addressing social needs, such as housing and transportation —also referred to as “social determinants of health”. In 2012, Oregon advanced its social determinants of health and health equity plans through spending mechanisms and contractual requirements with its 16 coordinated care organizations, a type of managed care entity responsible for the health care outcomes and costs of Medicaid members in its region. This Issue Brief describes how a community and health plan leveraged shared goals to address social determinants of health and health equity for the coordinated care organizations and its surrounding region.