Food for Thought: Medicaid Nutrition Benefit Design Approaches for Equitable Implementation

CHCS October 10, 2024
Kathryn Jantz, HealthBegins, and Amanda Bank, Center for Health Care Strategies

State Medicaid agencies are increasingly seeking to address Medicaid members’ health-related social needs (HRSN). In November 2023, the Centers for Medicare & Medicaid Services (CMS) released state guidance explicitly outlining allowable HRSN interventions under Medicaid and CHIP authorities (i.e., In Lieu of Services (ILOS)), Home- and Community-Based Services (HCBS), and 1115 waivers). This guidance pre-approves certain interventions related to nutrition and housing. CMS allowable nutrition supports include:

• Case management for access to food/nutrition;
• Nutrition counseling and instruction;
• Home-delivered meals or pantry stocking tailored to health risk and eligibility category;
• Nutrition prescriptions tailored to health risk or nutrition-sensitive conditions; and
• Grocery provisions.

Data show nutrition insecurity is the most common social need among Medicaid members. In addition, Medicaid-based nutrition...

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