Manatt Health October 25, 2021
Mandy Ferguson, Naomi Newman

Overview

Increasingly, states are using their Medicaid managed care (MMC) contracts to define the role Medicaid and Medicaid managed care plans can play in addressing unmet social needs and promote a “whole person” approach to care. A few leading states are leveraging contracts with Medicaid managed care organizations (MCOs) to require health plan investment into the community being served. This article describes the context for these requirements and sample approaches for state Medicaid agencies to integrate community investment strategies into MMC contracts.

Community Investments Are Critical Now, More Than Ever

There is a growing recognition that socioeconomic factors significantly affect health outcomes—research suggests that 80 percent of an individual’s health outcomes are attributable to nonmedical factors.1 Often referred to as...

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Topics: Equity/SDOH, Govt Agencies, Healthcare System, Insurance, Medicaid, Patient / Consumer, Payer, Provider, States
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