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Addressing Social Determinants of Health Through Medicaid

  • By: NYSHealth
  • Date: January 2017
  • Priority Area: Advancing Primary Care
  • Type: Grant Outcome Reports
  • Category: Grant Outcome Report
  • Grantee Name: Milbank Memorial Fund

Overview

Social factors, such as income, access to food and housing, and employment status, have a significant impact on the health and health outcomes of Americans, particularly lower-income populations. Faced with mounting evidence on the importance of these social factors, state Medicaid agencies are looking for ways to integrate social interventions into their coverage, payment, and delivery models to improve the health of Medicaid beneficiaries, who are often the costliest and most complex patients. As they do so, states must decide which social interventions Medicaid should cover, recognizing that Medicaid is not a social services program and that there are limits on how it can be used. Although New York State’s interest in responding to these issues is strong, policymakers lacked actionable information on when and how Medicaid can play a role. NYSHealth joined with the Milbank Memorial Fund to develop an issue brief that provides State officials with practical guidance on how Medicaid can be used to address social determinants of health.

Grantee: Milbank Memorial Fund / MMF

Dates: October 2015 – August 2016

Grant Amount: $25,000

Grantee Website: http://www.milbank.org

Grant ID: 15-03592


Outcomes and Lessons Learned:

  • Produced the issue brief, in conjunction with Manatt Health, “Medicaid Coverage of Social Interventions: A Road Map for States,” and released it in July 2016;
  • Described the legal and regulatory provisions that authorize Medicaid coverage of social support services;
  • Explained Medicaid’s role in facilitating social support services in four areas: linkages to social service programs, stable housing, employment and job stability, and peer and community supports; and
  • Provided examples of states that are administering these services through Medicaid.

 

Following the release of the issue brief, NYSHealth hosted a public discussion, "A Conversation About Medicaid Coverage of Social Interventions." The discussion panel included the report’s co-author and representatives from the New York State Department of Health, insurers, and provider systems. Milbank Memorial Fund has since organized several activities around the report, including a webinar for Reforming States Group (RSG), a bipartisan, voluntary association of state executive and legislative officials, in which more than 100 members participated. The report’s co-author also presented the paper to 108 participants at RSG’s fall 2016 meetings, which included Medicaid and public health directors, Governor’s Office senior health policy staff, and chairs/vice chairs of health care, public health, appropriations, and budget committees.

Co-Funding and Additional Funds Leveraged: Milbank Memorial Fund co-funded this project ($25,000).