State Expectations and Medicaid Managed Care Organizations’ Efforts to Address the Social Needs of Medicaid Enrollees
Document Type
Article
Publication Date
6-2-2022
Publication Title
Medical Care Research and Review
DOI
10.1177/10775587221096262
Abstract
Existing work on states’ efforts to address the social needs of Medicaid enrollees indicate the implementation of several state-level strategies to move Medicaid Managed Care Organizations (MMCOs) toward the provision of whole-person care. However, less is known about how these expectations drive MMCOs’ SDOH efforts. To address this gap, we interviewed representatives of eight MMCOs (N=28) and 12 state Medicaid offices (N=17). Participants described varying state-implemented instruments for encouraging an SDOH-focus among MMCOs, including both coercive (e.g., contractual mandates) and subtle approaches (e.g., request for proposal process and performance measurement expectations). However, regardless of states’ expectations, MMCOs, driven by organizational and industry-related factors, recognized the importance of addressing SDOH as part of a holistic approach to health care. Collectively, regulatory pressures, organizational strategy, and market forces influenced MMCOs’ efforts to address SDOH leading to a normalization of their role in addressing members’ social needs within a medical paradigm.
Recommended Citation
Opoku, Samuel T., Charles F. Owens, Bettye Apenteng, Linda Kimsey, Angela H. Peden.
2022.
"State Expectations and Medicaid Managed Care Organizations’ Efforts to Address the Social Needs of Medicaid Enrollees."
Medical Care Research and Review, 79 (6): SAGE Publication.
doi: 10.1177/10775587221096262
https://digitalcommons.georgiasouthern.edu/hpmb-facpubs/263
Copyright
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Comments
Georgia Southern University faculty members, Samuel T. Opoku, Charles F. Owens, Bettye A. Apenteng, Linda Kimsey, and Angela H. Peden co-authored State Expectations and Medicaid Managed Care Organizations’ Efforts to Address the Social Needs of Medicaid Enrollees.