At the end of the federal public health emergency, states will need to redetermine eligibility for nearly all Medicaid enrollees in the largest healthcare event since the Affordable Care Act. In order to avoid potential coverage losses, states will need to communicate with enrollees and other stakeholders about the actions they need to take to keep individuals enrolled in Medicaid or transition to another form of health coverage. One way that states are promoting transparency in their communications and planning efforts is through the public release of their unwinding operational plans. This expert perspective highlights several states that have made their unwinding operational plans publicly available as well as examples of states’ ongoing communication efforts, including outreach campaigns to Medicaid enrollees, strategies for collaborating with stakeholders, and collaborative initiatives within Marketplace states. This expert perspective has been updated as of November 17, 2022 to reflect recently released state unwinding operational plans.
Addressing Health-Related Social Needs Through Medicaid Managed Care
Erin Campbell, Mary Beth Dyer, and Erin Taylor, Bailit Health
States are using a variety of approaches to measure and incentivize Medicaid managed care (MMC) entities to address unmet social needs that can contribute to poor health outcomes, lower quality care, and higher medical expenditures. This toolkit identifies examples of approaches states are taking through their MMC programs to address health-related social needs. States interested in implementing specific strategies related to social determinants of health (SDOH) can use this toolkit to develop managed care procurements or update and operationalize key contract provisions. The toolkit does not include all state MMC procurement questions or contract language related to addressing enrollees’ SDOH needs, but instead represents a curated list of specific examples from 16 profiled states. This toolkit was co-funded by the Health Foundation of South Florida.