Abstract
OBJECTIVES: Many Medicaid managed care organizations (MCOs) now screen enrollees and connect them to community-based organizations (CBOs) to address unmet social needs. COVID-19 has significantly disrupted health care delivery and overall economic activity in the United States. We examined how partnerships between Medicaid MCOs and CBOs to address social determinants of health have been affected by the pandemic. STUDY DESIGN: Guided by questions and recruitment strategies developed with our stakeholder advisory board, we conducted 26 interviews with representatives from all 6 of Kentucky’s Medicaid MCOs. METHODS: In-depth, structured interviews for data collection and iterative content analyses to identify themes. RESULTS: Several themes emerged, including substantial increases in enrollees’ unmet needs and the demand to find new ways to be responsive, changing funding patterns, disruptions to and evolving modes of communication, and shifting partner relationships. In virtually all areas of impact, COVID-19 has been associated with both negative and positive change. CONCLUSIONS: Unmet social needs associated with the pandemic placed tremendous strain on CBOs, limiting their capacity to sustain some programs and partnerships. Isolation associated with COVID-19 also had wide-ranging effects on service delivery, communication with enrollees and partners, and the ability to maintain relationships. Nonetheless, the pandemic also had some silver linings, including additional resources and flexibility for addressing unmet needs. Federal and state agencies, along with MCO leaders, should carefully evaluate what innovations have been particularly effective during the pandemic and craft new flexibilities into their policies, procedures, and regulations.
| Original language | English |
|---|---|
| Pages (from-to) | 136-141 |
| Number of pages | 6 |
| Journal | American Journal of Managed Care |
| Volume | 29 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2023 |
Bibliographical note
Funding Information:This research was supported by a grant from the Robert Wood Johnson Foundation as part of the Research in Transforming Health and Health Systems Program (Grant ID 77256). Research reported in this publication was also supported by the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services, under Agreement C2517 titled “Medicaid Managed Care Organizational Strategies to Address Enrollee Unmet Social Needs.” The content is solely the responsibility of the authors and does not necessarily represent the official views of the Cabinet for Health and Family Services, Department for Medicaid Services.
Funding Information:
Source of Funding: This research was supported by a grant from the Robert Wood Johnson Foundation as part of the Research in Transforming Health and Health Systems Program (Grant ID 77256). Research reported in this publication was also supported by the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services, under Agreement C2517 titled “Medicaid Managed Care Organizational Strategies to Address Enrollee Unmet Social Needs.” The content is solely the responsibility of the authors and does not necessarily represent the official views of the Cabinet for Health and Family Services, Department for Medicaid Services.
Publisher Copyright:
© 2023 Authors. All rights reserved.
ASJC Scopus subject areas
- Health Policy
