Medicaid Managed Care Organization Learning Hub
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.
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.
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.
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Data & Findings
New Managed Care - Webinar Series
Funded by MolinaCares Accord
MCO Learning Hub - Webinar Series
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 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
- Approaches and Strategies for Community Based Organizations to Engage with Managed Care Organizations: Building Strategic Partnerships: On December 3, 2020, the MCO Learning Hub held the fourth segment of the four-part Medicaid Managed Care 101 Series (slides, recording and Q&A) which in part covered MCO engagement. This issue brief builds on the webinar by providing CBOs specific guidance and a strategy for engaging with MCOs.
- Spotlight on MCO-CBO Partnerships: CareOregon and JOIN Partnership to Offer Housing Supports: NORC spoke with CareOregon and JOIN to discuss how this partnership works to provide permanent supportive housing supports and other wraparound services to Medicaid members. CareOregon is a safety net, nonprofit managed care plan for low-income Oregonians. JOIN is a nonprofit organization that supports individuals and families experiencing homelessness in the Portland Metro area. This spotlight highlights the formation and logistics of the partnership, programs they offer, lessons learned, and the future of the partnership.
- Spotlight on MCO-CBO Partnerships: UPMC Health Plan and CHS Partnership on Cultivating Health for Success: NORC spoke with UPMC Health Plan and Community Human Services (CHS) to discuss their partnership in running the Cultivating Health for Success program. UPMC Health Plan, part of the UPMC integrated delivery and finance system headquartered in Pittsburgh, Pennsylvania, provides services to members throughout Pennsylvania and parts of Ohio and Maryland. CHS is a Pittsburgh-based nonprofit that empowers individuals and families to live in stable housing, connect to community resources, build relationships, and access quality food. This spotlight highlights the formation and logistics of their partnership, including the background, services offered, and goals.
- Spotlight on MCO Partnerships: Children’s Community Health Plan (CCHP) and Milwaukee County Housing Division (MCHD) Partnership to Provide Housing Support to Medicaid Members: NORC spoke with CCHP and MCHD to discuss their unique partnership, between a nonprofit health plan in Wisconsin (CCHP) and a local government housing division (MCHD), where CCHP’s financial support helps the plan’s Medicaid members find, obtain, and maintain affordable housing units in Milwaukee County.
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.
- 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 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 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.