Medicaid Managed Care Organization Learning Hub

Medicaid managed care plans require current, trustworthy information to provide high-quality care to all Americans in our shifting health care landscape.


Managed care organizations (MCOs) are looking for ways to improve the physical and behavioral health outcomes and address the social needs of their members. Funded by the Robert Wood Johnson Foundation, the NORC MCO Learning Hub is committed to providing information on ways to transform health equity and health care to key MCO leadership, consumer groups, state Medicaid leaders, and other stakeholders.

The Learning Hub offers reliable and timely resources, as well as opportunities for stakeholders to convene and share ideas about short- and long-term strategies that can close longstanding and growing health gaps among groups who lack what they require to live their healthiest lives. NORC and its partners—Speire Healthcare Strategies, America’s Health Insurance Plans, the Association for Community Affiliated Plans, Community Catalyst, and Families USA—are working together on this project to support MCOs in their efforts to establish a more integrated approach to meet the needs of their members through the MCO Learning Hub.

Your ideas and opinions are important to us. We welcome your feedback and recommendations for future MCO Learning Hub work, as well as programs you are working on to better serve your needs.
To start the conversation and/or be added to our distribution list, please email us at MCOLearningHub@norc.org.

MCO Partnerships to Support Medicaid Member Housing Needs

MCO partnerships, often with community-based organizations (CBOs), are critical to advancing SDOH-related services and supports to Medicaid members. Given the importance of stable housing to one’s health and well-being, MCOs are increasingly partnering with CBOs or local government entities to deliver housing related services to Medicaid members. The below Spotlights highlight key insights and innovations for MCO partnerships related to housing.

  • 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

Achieving health and health equity goes beyond addressing individuals’ medical concerns—policymakers must also take into account the social, economic, and environmental factors and racial inequities that influence individuals’ health and lived experiences. Through the Learning Hub, NORC has synthesized insights and information related to best practices in the field, lessons learned, and potential next steps for MCOs and developed materials on SDOH topics and how MCOs are identifying social risk factors and responding to emergent needs – these materials are presented below.

  • 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.
  • 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.
  • 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.

Homelessness

A key SDOH factor is an individual’s neighborhood and built environment, which includes their quality of housing. Many individuals experiencing homelessness or inadequate shelter have chronic mental or physical health conditions and experience a lower quality of life. Due to the COVID-19 pandemic, an increasing number of individuals are experiencing homelessness and job loss and, therefore, are more vulnerable to negative health outcomes and health inequities. Medicaid programs and MCOs have an increasing role in supporting Medicaid members’ housing needs and key insights and innovations are highlighted in the materials below.

  • 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

A critical area of focus in addressing SDOH is regular access to nutritious and healthy meals. When individuals or families have limited ability or recourses to attain proper nutrients—or have low food security—the health consequences of one’s diet ripple through to other physical and mental health issues. In light of the COVID-19 pandemic, school closures, and social distancing restrictions, many already and newly food insecure populations have experienced an increased difficulty in accessing food. Many more vulnerable groups have become food insecure due to loss of work and/or income. Medicaid programs, health systems and MCOs have increased access to nutritious food for these populations and these key insights and innovations are profiled below.

  • 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

Ensuring adequate access to timely and well-coordinated behavioral health services to Medicaid members is complex and challenging. COVID-19 has increased the needs among many people for BH care, particularly for those with pre-existing mental health conditions and substance use disorders (SUDs). With in-person clinical services shut down or scaled back, social distancing, fears about contracting COVID-19, limitations in transportation, and challenges accessing telehealth for some populations, access to needed behavioral health services has become more challenging. How Medicaid programs cover these services and how MCOs provide these services is of increasing importance – key insights, including barriers and opportunities are highlighted in the materials below.

  • 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.

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.

MCO LEARNING HUB WEBINAR SERIES

MCO Investments in Affordable Housing
February 2, 2021 – 2:00 p.m. ET
Video Recording | Presentation Slides

Medicaid MCO Overview and Financing Webinar
November 19, 2020 – 1:00 p.m. ET
Video Recording | Presentation Slides | Q&A

Medicaid MCO Authorities and Partnership Strategies Webinar
December 3, 2020 - 3:00 p.m. ET
Video Recording | Presentation Slides | Q&A

COVId-19 Resources


Focus on a COVID-19 Vaccination: The Role of Medicaid Managed Care Organizations: This brief, developed from group discussions with MCOs and CBOs on member engagement, highlights the role of MCOs in COVID-19 vaccine distribution efforts as well as in building public trust for vaccination.

Medicaid Managed Care Response to COVID-19: This issue brief addresses how Medicaid MCOs and states can individually and collectively play a role in responding to the COVID-19 pandemic.

Pandemic Unveils Challenges in Access to Health Care and Trusted Sources of Information

Concerns over Getting Sick with COVID-19 and Paying for Health Care Disproportionately Affect Communities of Color

PROJECT OVERVIEW

Medicaid MCO (MMCO) Learning Hub

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Medicaid MCO (MMCO) Learning Hub

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