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Medicaid Managed Care Organization Learning Hub

Mobile connection illustration, do it with chalk
Working with insurance plans, providers, and patient advocates to improve Medicaid equity and outcomes
  • Client
    MolinaCares Accord
  • Dates
    2019 - 2022

Problem

State Medicaid leaders, community partners, and managed care organizations require current, trustworthy information in our shifting health care landscape 

Because of their disadvantaged circumstances, people insured through Medicaid tend to experience poorer health outcomes and less equitable treatment than other Americans. Medicaid managed care organizations (MCOs), which most states rely on to manage Medicaid health plans, may be earnest in their efforts to provide top-quality care. But patients’ well-being can be impaired by factors outside the purview of medical professionals, such as food insecurity, homelessness, and behavioral health disorders. 

Solution

NORC offered reliable and timely resources and strategies to advance health equity for Medicaid populations. 

NORC and its partner, Speire Healthcare Strategies, LLC, teamed with America's Health Insurance Plans and the Association for Community Affiliated Plans and Community Catalyst and Families. Together, we hosted a series of wide-ranging discussions with MCOs and advocates on how MCOs could collaborate with community-based organizations to improve the overall health of Medicaid enrollees. In these roundtables, we identified barriers that separated these would-be allies to produce a series of briefs with findings and recommendations from these discussions. We also research briefs based on literature reviews and spotlights based on discussions with states and other organizations to highlight best practices that could be copied elsewhere.

Result

Managed Care Organizations now have practical guidance to improve Medicaid patient health. 

In addition to presenting policy recommendations to the Robert Wood Johnson Foundation and our project partners, we published a dozen articles on our NORC Learning Hub highlighting examples of role-model collaborations. Findings highlight takeaways from the three project focus areas—social determinants of health, behavioral health, and member engagement—as well as other timely topic areas. These include MCO's response to the COVID-19 pandemic, investments in affordable housing, and health equity efforts. With funding from the MolinaCares Accord, we also hosted a six-part webinar series that focused on lessons learned from other innovative approaches to Medicaid managed care nationwide.

Project Leads

“There is substantial opportunity for Medicaid managed care organizations, working with local community-based organizations, to greatly improve the health outcomes and health equity of Medicaid enrollees.”

Vice President

“There is substantial opportunity for Medicaid managed care organizations, working with local community-based organizations, to greatly improve the health outcomes and health equity of Medicaid enrollees.”

New Managed Care - Webinar Series

Funded by MolinaCares Accord

Building Current and Future Capacity in the Healthcare Workforce

December 2022

Successful Strategies in Behavioral Health Integration

October 2022

How Can States Engage with Health Plan Foundations to Address Health Disparities

July 2022

How States Can Use ARPA Funding to Support HCBS Technology Needs

March 2022

Addressing the Care Fragmentation Crisis for Dually Eligible Individuals

November 2021

Meeting the Behavioral Health Needs of Medicaid Members Post-Pandemic

July 2021

MCO Healthy Equity Efforts

  • Challenges and Opportunities for Advancing Health Equity in Managed Care Organizations: The MCO Learning Hub conducted interviews with five MCOs to gather their perspectives on how they plan to address health equity. This issue brief highlights the main takeaways from those discussions, which detail current challenges, initiatives, and the road ahead.
  • Spotlight: AmeriHealth Caritas: NORC spoke with AmeriHealth Caritas to discuss their efforts to move toward health equity and mitigate systemic racism within their organizations and through their relationships with other health care entities. This spotlight highlights defining health equity, strategies for promoting health equity, challenges and lessons learned.
  • Spotlight: Gateway Health: NORC spoke with Gateway Health to discuss their efforts to move toward health equity and mitigate systemic racism within their organization and related health systems. This spotlight highlights defining health equity, health equity goals and objectives, COVID-19 vaccination and health equity, and next steps.
  • Spotlight: Health Services for Children with Special Needs, Inc. (HSCSN): NORC spoke with HSCSN to discuss their efforts to move toward health equity and mitigate systemic racism within their organization and related health systems. This spotlight highlights the background of HSCSN, defining health equity, efforts to advance health equity, challenges and lessons learned.

Member Engagement

  • Member Engagement Discussion Group Series: In November-December 2020, the NORC team convened four discussion groups, one with each of its Medicaid MCO Learning Hub partners—Community Catalyst, ACAP, AHIP, and Families USA—and their affiliated Medicaid MCOs and advocacy experts to discuss challenges with member and family engagement, strategies for better engagement, and how COVID-19 affected engagement efforts. After assessing key themes, the team convened a Roundtable with representatives from across the four partners to discuss main findings and identify key insights and opportunities around member engagement.
  • Spotlight: Commonwealth Care Alliance (CCA): NORC spoke with CCA to discuss their strategies for promoting authentic member engagement internally and working with other organizations to advance consumer partnership.
  • Spotlight: Banner Health and the Arizona Health Care Cost Containment System (AHCCCS): NORC spoke with Banner Health and AHCCS about working together to elevate consumer voices using advisory councils, including state requirements, challenges with member engagement, and facilitators and lessons learned.

Strategies for Engaging MCOs and MCO Partnerships to Support Medicaid Member Housing Needs

Social Determinants of Health

  • COVID-19’s Impact on Medicaid Enrollees’ Social Determinants of Health: This issue brief presents areas the Medicaid MCO Learning Hub will be tracking as the COVID-19 pandemic has evolved, and provides examples of how MCOs are addressing these issues. This brief is intended to support RWJF, RWJF-funded organizations, MCOs, and other organizations to advance health equity by presenting timely topics and examples of leading organizations’ efforts in these topic areas.
  • SDOH Discussion Group Series: In July and August 2020, the NORC team convened four discussion groups with each of its four Medicaid MCO Learning Hub partners – Community Catalyst, ACAP, AHIP, Families USA – and their affiliated Medicaid MCOs and advocacy experts. We also convened a final Roundtable with representatives from each organization. This brief synthesizes discussions focused on the SDOH needs of their members and how COVID-19 is affecting those needs as well as insights and opportunities for addressing what we learned.
  • Spotlight: Texas MCO SDOH Learning Collaborative: NORC recently communicated via email with members of the Texas MCO SDOH Learning Collaborative about their initiative, comprised of foundations, two state health plan associations, a state Medicaid agency and a research organization, to drive the development of social needs interventions for Medicaid beneficiaries. The goals, activities, challenges, successes and lessons learned explored in this Spotlight may serve as an example for other organizations interested in developing their own state-focused cross-sector learning collaborative to identify Medicaid policy solutions.
  • Spotlight: Karin VanZant, CareSource: NORC spoke with Karin VanZant, Vice President of Integrated Community Partnerships and Executive Director of Life Services at CareSource, to discuss racial and ethnic disparities in health care exposed by COVID-19, as well as efforts to advance social determinants of health initiatives among Medicaid MCOs. This spotlight highlights the conversation around these topics.
  • Spotlight: Dr. Garth Graham, CVS: NORC spoke with Dr. Garth Graham, Vice President, Community Health and Chief Community Health Officer at CVS Health to discuss racial and ethnic disparities in health care exposed by COVID-19 as well as efforts to advance SDOH initiatives among Medicaid MCOs.

Homelessness

  • MCOs’ Role in Combatting Homelessness in the Wake of COVID-19: This issue brief reviews the impact of homelessness on health outcomes, what state Medicaid programs and MCOs have done for this population pre-COVID-19, what they are doing now, and strategies they can consider in the future.
  • Spotlight: Circle the City: NORC spoke with Linda Ross, CEO of Circle the City, to discuss how the federally-qualified health center works with MCOs and other service organizations to provide medical and other social services to individuals experiencing homelessness in Maricopa County, Arizona. This spotlight highlights the conversation around Circle the City’s mission, how COVID-19 has impacted the organization’s work, how it partners with MCOs and other community-based organizations, and what lessons learned can be derived from the Circle the City model.

Food Insecurity

  • Food Insecurity Brief: This brief summarizes how food insecurity impacts health outcomes, how the COVID-19 pandemic has exacerbated this issue, and what strategies MCOs have used and can use to address the issue and support their communities. The brief is intended to support RWJF, RWJF-funded organizations, MCOs, and other organizations to advance health equity by presenting timely topics and providing examples of leading organizations and their efforts in these topic areas.
  • Spotlight: Second Harvest Heartland’s FOODRx: NORC spoke with Alexandra De Kesel Lofthus, Former Director of Health Care Partnerships at Second Harvest Heartland, to discuss how Second Harvest Heartland works with health care systems to address food insecurity. FOODRx partners with Medicaid MCOs and Minnesota’s Integrated Health Partnerships (IHPs) to provide food resources and nutrition solutions for their members or attributed populations. This spotlight highlights the conversation around what the FOODRx program is, how the organization works with Medicaid MCOs, the impact of COVID-19 on their work, and what lessons learned can be derived from these partnerships.

Behavioral Health

  • Behavioral Health Discussion Group Series: In September and October 2020, NORC convened four discussion groups, one with each of its Medicaid MCO Learning Hub partners – Community Catalyst, ACAP, AHIP, Families USA – and their affiliated Medicaid MCOs and advocacy experts to discuss the behavioral health needs of their members, the delivery of behavioral health services to Medicaid members, and how COVID-19 is affecting those needs. We also convened a Roundtable with representatives from across the four partner organizations to discuss key insights and opportunities around behavioral health.
  • Spotlight: Dr. Parinda Khatri, Cherokee Health Systems: NORC spoke with Dr. Parinda Khatri, Chief Clinical Officer at Cherokee Health Systems to discuss how COVID-19 has affected the delivery of behavioral health services, the rise of telehealth, and working with CBOs and MCOs to meet the growing need for behavioral health services.

Explore NORC Health Projects

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New and improved processes for collecting and using Maine’s health care claims data

Client:

Human Services Research Institute (HSRI)

Understanding California’s Middle-Income Older Adult Population

California’s middle-income seniors projected to grow to 1.6M by 2033

Client:

The SCAN Foundation, West Health