CareFirst BlueCross BlueShield (CareFirst) recently hosted a panel discussion, More than Medicine: How Medicaid Addresses Social Needs. The event included opening comments by Kimberly Y. Robinson, J.D., Vice President of State Government Affairs, and was moderated by Sheila Yahyazadeh, Chief External Operations Officer of CareFirst Community Health Plan Maryland (CHPMD). Panelists included:
- Matt Salo, Former Executive Director, National Association of Medicaid Directors (NAMD); Founder and CEO, Salo Health Strategies
- Jami Snyder, Former Director, Arizona Health Care Cost Containment System (AHCCCS); Chief Executive Officer and President, JSN Strategies LLC
- Rodney Whitlock, Ph.D., Former Health Policy Advisor on the Senate Finance Committee Republican Staff; Vice President, McDermott + Consulting.
Medicaid, which is jointly funded by the states and federal government, provides health coverage to roughly 80 million low-income individuals in the United States. These individuals are disproportionately from historically marginalized populations that have a diverse range of health-related social needs that can profoundly impact their well-being. In fact, it is often noted that 80% of one’s health outcomes are determined by non-medical factors, such as access to nutritious food and stable housing.
Medicaid has been and continues to be at the forefront of addressing these health-related social needs through a variety of initiatives including value-added benefits, in-lieu of services, and Section 1115 waivers. These initiatives play an important role in offsetting costs from other parts of the healthcare system and reducing financial burden on hospitals and healthcare providers, particularly during public health emergencies, such as the COVID-19 pandemic.
While health programs like Medicaid play a critical role in addressing health-related social needs, they are not intended to replace efforts by other federal, state and local social service programs that address these social needs. Instead, Medicaid complements these efforts through partnerships to provide comprehensive whole-person care to enrollees.
During the conversation, the panelists provided their thoughts on a range of topics including:
- The importance of partnership among managed care organizations, community-based organizations, states and the federal government in addressing health-related social needs of Medicaid enrollees. Notably, public-private partnerships are a way to go to market faster, iterate quickly and demonstrate the value of new programs or offerings for plan members and the state. Panelists also highlighted the value of inter-agency collaboration at the federal and state level in addressing health disparities and proactively addressing barriers to accessing care.
- The role of managed care organizations as financial stewards of the state and federal dollars and partners in helping to manage costs through programs that directly address care needs and the drivers, such as food insecurity, that lead people to use emergency services and high-cost care settings.
- How states and managed care organizations optimize healthcare services for Medicaid enrollees and the increasing need to emphasize program efficiency in meeting enrollees’ medical and non-medical needs.
- Amidst growing federal and state fiscal pressures, the importance of appropriately measuring, demonstrating and communicating the value of Medicaid, including financial return on investment and improvements in health outcomes achieved by programs and initiatives that provide social supports.
- The potential impacts of the next presidential administration and Congress on efforts to address health-related social needs in underserved populations.
CareFirst believes addressing unmet social needs for Medicaid enrollees is critical for driving improved health outcomes and helping control healthcare costs. The examples, strategies and lessons learned shared during our recent event highlight the opportunities and challenges ahead for this critical work.
If you missed the event, you can catch up on the insightful discussion and learn about the innovative strategies shaping the future of Medicaid by watching the video.