Affiliation:
1. Georgia Southern University, Statesboro, USA
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.
Funder
Robert Wood Johnson Foundation
Reference26 articles.
1. Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy
2. America’s Health Insurance Plans. (2020, May). The value of medicaid managed care: Innovating in Medicaid. https://www.ahip.org/wp-content/uploads/The-Value-of-Medicaid_Report.pdf
3. Using thematic analysis in psychology
4. Change Healthcare. (2018). The 8th annual industry pulse report: A national survey of leading health plans and other healthcare stakeholders. change healthcare. http://bit.ly/2nPLrBd
5. Social determinants of health priorities of state Medicaid programs
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献