Opportunities for States – National Academy of Social Insurance

In an environment of uncertainty surrounding the future of Medicaid policy and funding, addressing the social determinants of health to improve the health status of Medicaid recipients could be seen as an unaffordable luxury. But there is a strong business case for state Medicaid programs to address the social determinants of health as a key strategy for providing cost-effective and efficient care. By partnering with state and local agencies to address the social determinants of health, state Medicaid leaders can improve their ability to control costs and strengthen the long-term financial sustainability of the program.

This guidance note explains how state Medicaid agencies and managed care organizations can address the social determinants of health (SDH). It reviews the evidence demonstrating a link between health status and SDH, summarizes the business case for Medicaid to support interventions aimed at addressing SDH, describes current opportunities and limitations in the use of SDH. Medicaid as a lever to fight SDH and discusses new perspectives for the state. policy makers to tackle SDH in today’s environment.

This thesis was supported by the Robert Wood Johnson Foundation in collaboration with the project Strengthen Medicaid as an essential lever in the construction of a culture of health.