Addressing the Social Needs of Medicaid Enrollees Through Managed Care: Lessons and Promising Practices from the Field

This publication describes the perspectives of Medicaid managed care organizations (MMCO) representatives on the lessons learned and emerging promising practices from addressing social determinants of health (SDOH) among their Medicaid enrollees.

Using data from interviews with 28 representatives of eight national and regional MMCOs, this qualitative study describes the perspectives of MMCO representatives on the lessons learned and emerging promising practices from addressing SDOH among their Medicaid enrollees. Participants discussed the importance of member and community-centeredness, structured programming, and delivery system realignment in the effective delivery of whole person care.

Findings from this study suggest that success in addressing the social needs of Medicaid beneficiaries may be achieved through adaptive, data-driven, member- and community-centric efforts by MMCOs, facilitated by system-level changes that formally integrate social services within healthcare.