Social determinants of health priorities of state Medicaid programs

BMC Health Serv Res. 2019 Mar 14;19(1):167. doi: 10.1186/s12913-019-3977-5.


Background: Growing understanding of the influence of social determinants of health (SDH) on healthcare costs and outcomes for low income populations is leading State Medicaid agencies to consider incorporating SDH into their program design. This paper explores states' current approaches to SDH.

Methods: A mixed-methods approach combined a web-based survey sent through the Medicaid Medical Director Network (MMDN) listserv and semi-structured interviews conducted at the MMDN Annual Meeting in November 2017.

Results: Seventeen MMDs responded to the survey and 14 participated in an interview. More than half reported current collection of SDH data and all had intentions for future collection. Most commonly reported SDH screening topics were housing instability and food insecurity. In-depth interviews underscored barriers to optimal SDH approaches.

Conclusion: These results demonstrate that Medicaid leaders recognize the importance of SDH in improving health, health equity, and healthcare costs for the Medicaid population but challenges for sustainable implementation remain.

Keywords: Equity; Health insurance; Low-income; Medicaid; Population health; Social determinants.

MeSH terms

  • Food Supply
  • Health Equity / economics
  • Health Equity / organization & administration
  • Health Priorities / economics
  • Health Priorities / organization & administration
  • Health Services Research
  • Housing / statistics & numerical data
  • Humans
  • Medicaid / economics
  • Medicaid / organization & administration*
  • Poverty / economics
  • Poverty / statistics & numerical data
  • Social Determinants of Health*
  • State Government
  • United States