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Medicaid and Social Determinants of Health: Adjusting Payment and Measuring Health Outcomes

State Health and Value Strategies of the Robert Wood Johnson Foundation and Woodrow Wilson School of Public and International Affairs

With the support of State Health and Value Strategies, Ellen Breslin and Anissa Lambertino of Health Management Associates, in partnership with Dennis Heaphy of the Disability Policy Consortium and Tony Dreyfus, prepared a recently released issue brief “Medicaid and Social Determinants of Health: Adjusting Payment and Measuring Health Outcomes.”

This brief answers two key questions for state policy makers:

  1. Why should Medicaid programs account for social determinants of health (SDOH) in setting payments and in measuring quality?
  2. What methods can Medicaid programs use to examine SDOH and account for them in their payment and/or quality improvement policies?

Case studies from Medicaid agency efforts in both Massachusetts and Minnesota will be used to answer these questions.

This brief was prepared to accompany the recent State Health and Value Strategies webinar “Using Social Determinants of Health Data in Medicaid Managed Care.”

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