Jan 5, 2023 - Health

CMS allows Medicaid to address unmet social needs

Illustration of a key ring hanging on an IV pole.

Illustration: Shoshana Gordon/Axios

The Biden administration on Wednesday gave states more leeway to cover services addressing health-related social needs under their Medicaid programs.

Why it matters: Addressing "social determinants" like housing, transportation and food security could reduce hospital admissions and overall health spending. But researchers have questioned whether the cost of such interventions may eclipse the potential savings.

Driving the news: The Department of Health and Human Services issued guidance letting states use Medicaid managed care to offer alternative benefits addressing unmet needs, and outlined requirements for showing the efforts are cost-effective.

  • Services could include special meals for people with chronic health conditions made worse by poor diet, or for those without access to nutritious food choices, per the Centers for Medicare and Medicaid Services.

Zoom out: Some states already use alternative benefits under Medicaid to increase access to inpatient mental health and substance use disorder services.

  • The new flexibilities would encourage medically appropriate substitutes for state-covered services and would augment the Biden administration's ongoing efforts aimed at reducing hunger and diet-related diseases by 2030.

Background: North Carolina's approach to Medicaid has been held up as an example of how to address social determinants of health, Politico previously reported.

  • The state launched an online social service referral program in some counties to help social workers and health care case workers get people help, per the report.
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