Medicaid programs have become incubators for innovation in health equity and action on the social determinants of health.
For example, at the behest of the federal government, states are expanding access to maternity services and clinical trials. Twenty-seven states have expanded coverage of doula services for up to 12 months through financial incentives offered under the American Plan of Rescue Act of 2021. and postpartum periods.
The new federal requirements have also pushed Medicaid agencies to start covering the costs of treatment in clinical trials. Guaranteed coverage should allow more low-income people to access new treatments and technologies, as well as reduce research time.
States have also taken initiatives on the mental health crisis, the opioid epidemic, homelessness and poverty, and are promoting managed care plans to reduce health disparities by connecting members to community resources. Here are five states implementing new Medicaid initiatives that promote health equity:
Oregon: Beaver State was the first to receive approval from the Centers for Medicare and Medicaid Services to cover mobile emergency services through the Oregon Health Plan, its Medicaid program. Beginning in January, stabilization services will primarily be deployed to help children, young people and their families experiencing behavioral crises, according to the state. Mobilization units are modeled after the Crisis Assistance Helping Out The Streets (CAHOOTS) program launched in Eugene, Oregon five years ago and will be connected to national emergency hotlines, including 988, which debuted this year to provide help in mental health emergencies.
North Carolina: His Medicaid program began a five-year, $650 million pilot program to study the impact of providing housing, food, transportation, and other social support to beneficiaries in need. This year, the program expanded these services to 33 counties in Tar Heel State, offering benefits including up to $1,250 per month in housing support, anti-violence funding, food delivery services, and transportation costs. The initiative also includes a team of care managers who coordinate primary care, mental health, and non-medical needs among high-risk participants.
Ohio: Medicaid has developed a managed care program for children with complex behavioral health needs called Ohio Resilience Through Integrated Systems and Best Practices. OhioRISE is known to coordinate services between schools, healthcare providers, health insurers, and community organizations for children and adults under the age of 20 who require major behavioral treatment. The program offers intensive home care, access to residential facilities, and mobile response and stabilization services. Ohio Medicaid also seeks to prevent children from being placed in state custody because their condition is not being treated.
California: The first wave of reforms under the Golden State’s ambitious five-year plan to transform Medi-Cal began in 2022. The State will reimburse services that will improve access for low-income populations and complement clinical care with non-medical services such as housing, meals, and peer support. Services launched this year include improved care management, dental care, and behavioral health support. Medi-Cal is also modifying its payment system to include features such as additional performance incentives and the inclusion of public health as reimbursable preventive care.
Arizona: A state Medicaid program called the Arizona Health Care Cost Containment System has received federal approval to reduce homelessness. Arizona will target people with mental illness, those who are pregnant, suffering from chronic illness, or leaving institutional settings such as prisons or mental institutions. The state expects to provide financial assistance to pay rent, utilities, housing deposits and other services to low-income applicants. Arizona Medicaid also coordinates preventive care, behavioral health services, substance use interventions, and other social support for eligible beneficiaries.