Medicaid MCOs Get Creative With Local SDOH Partnerships

From commercial insurers addressing lonely millennials to CMS allowing supplemental benefits that address non-medical needs for the Medicare Advantage population, social determinants of health (SDOH) are ubiquitous in health care these days. But Medicaid managed care organizations for years have been working within a fragmented delivery system and getting creative to address social determinants, which research has suggested drive up to 80% of health outcomes. Speaking at the 11th Annual Medicaid Innovations Forum, hosted by Strategic Solutions Network in Orlando from Feb. 5 to 7, several Medicaid insurers detailed how they are forging unique partnerships with local organizations to tackle a range of issues that often intertwine.

As the only not-for-profit insurer in its market that is owned by a network of 20 federally qualified health centers (FQHCs), it’s in the DNA of Community Health Plan of Washington (CHPW) to partner with its health centers “to work in the communities to address those social determinants of health that really impact our member population,” said Melissa Stevens, vice president of community engagement and growth. CHPW is also the only locally based plan in its market and competes with four national, for-profit insurers, she said.

© 2024 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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