The Centers for Medicare and Medicaid Services (CMS) issued guidance to states regarding strategies that address social determinants of health (SDOH) in the Medicaid CHIP program to address health outcomes, reduce health disparities, and lower costs. SDOH describe the range of social, environmental, and economic factors that can influence health status and may have a greater impact on health outcomes than the actual delivery of health services. The guidance describes how states can leverage existing flexibilities under federal law to tackle adverse health outcomes that can be impacted by SDOH and supports states with designing programs, benefits, and services that can more effectively improve population health and reduce cost.
The SDOH guidance details how state Medicaid and CHIP programs can utilize a variety of delivery approaches, benefits, and reimbursement methodologies to improve beneficiary outcomes. States can use different federal authorities that can provide them with flexibility to design an array of services to address SDOH and that can be tailored, within the constraints of certain federal rules, to address state-specific policy goals and priorities, including the movement from volume-based payments to value-based care, and the specific needs of states’ Medicaid and CHIP recipients.
The letter to State Health Officials is available here.