Key Findings from IMI’s 2020 Annual Medicaid MCO Survey: SDOH, Women’s Health, & Child Health

Key Findings from IMI’s 2020 Annual Medicaid MCO Survey: SDOH, Women’s Health, & Child Health

On December 8, 2020, the Institute for Medicaid Innovation (IMI) hosted a virtual event to support the release of its third annual Medicaid managed care organization (MCO) survey report, Medicaid Access and Coverage in 2019. The survey collected data on Medicaid MCOs that represented sixty-seven percent (67%) of covered lives in Medicaid managed care across almost every state, in eight categories.

During the virtual release event attendees participated in a live, virtual survey. Their responses indicated that, of the topics focused on in the survey report, social determinants of health (SDOH, 92%), women’s health (62%), and child and adolescent health (55%) were of the greatest interest. Key findings from these sections of the survey report are highlighted below.

Social Determinants of Health

Medicaid MCOs are in a unique position to address SDOH that affect the health and wellbeing of Medicaid enrollees, given their access to enrollee data, ability to use incentives, and relationships with states and community-based organizations (CBOs). In 2019, all (100%) survey respondents offered targeted SDOH programs for their members, most focused on addressing the needs of members who were homeless or housing insecure, pregnant, and who had serious mental illness. Nutrition and food security and housing were among the top social needs identified for members. In 2019, ninety-three percent (93%) of respondents screened for food and housing needs and led case management and care coordination programs for members experiencing homelessness or housing insecurity. To screen for social needs, half (50%) of MCOs used an internally developed or adapted screening tool. To find other IMI resources on SDOH and Medicaid managed care, click here.

Women’s Health

Medicaid MCOs are often responsible for managing the care of pregnant individuals and women enrolled in Medicaid across the lifespan. Additionally, almost half (43%) of births in the U.S. are covered by Medicaid. Almost all (93%) of survey respondents offered targeted women’s health programs in 2019. Prenatal and postpartum care was the highest women’s health priority topic (100%) followed by behavioral health (93%), and cancer screening/treatment (79%). Churn, or disruptions in coverage, is consistently a barrier for addressing the long-term health of women on Medicaid. In 2019, the top impacts of churn identified by respondents were disruptions to clinical care and care management continuity (77%). To find other IMI resources on women’s health topics in Medicaid managed care, click here.

Child and Adolescent Health

As of August 2020, over 37 million out of approximately 73 million children in the U.S. were enrolled in Medicaid, many of whom were covered by MCOs. MCOs therefore can support the health of children by implementing targeted programs and initiatives. All (100%) survey respondents offered child health programs in 2019. Common priority topics included children with special health care needs (CSHCN) (93%), ADHD/ADD (87%), behavioral health screening and treatment (80%), and asthma (80%). Barriers to care for CSHCN included carved out services such as those that are reimbursed on a fee-for-service basis and are not included in capitated arrangements (73%), and poor communication among multiple providers to families (60%). To find other IMI resources on child and adolescent health topics in Medicaid managed care, click here.

IMI’s 2021 annual Medicaid MCO survey was released on March 12th for health plans to complete. For the first time, the survey will include categories focused on COVID-19 and health equity & structural racism. IMI’s 2021 survey report has an anticipated release date in October of 2021; stay tuned! To receive notifications about recent IMI releases and upcoming events, sign up for IMI’s newsletter.