Federal laws, regulations, and programs offer numerous tools to states seeking to address social determinants of health through their Medicaid and Children’s Health Insurance Program (CHIP).  Now, Centers for Medicare & Medicaid Services has written to state Medicaid directors outlining those tools.

In the 51-page letter, CMS notes that

Many Medicaid and CHIP beneficiaries may face challenges related to SDOH [social determinants of health], including but not limited to access to nutritious food, affordable and accessible housing, convenient and efficient transportation, safe neighborhoods, strong social connections, quality education, and opportunities for meaningful employment.  There is a growing body of evidence that indicates that these challenges can lead to poorer health outcomes for beneficiaries and higher health costs for Medicaid and CHIP programs and can exacerbate health disparities for a broad range of populations…

In the letter, CMS describes:

  • Overarching principles CMS expects states to adhere to in their Medicaid and CHIP programs when offering services and supports that address social determinants of health.
  • Services and supports that are commonly covered in Medicaid and CHIP programs to address social determinants of health.
  • Federal authorities and other opportunities under Medicaid and CHIP that states can use to address social determinants of health.

The letter does not introduce new opportunities or flexibilities under Medicaid and CHIP for addressing social determinants of health. Instead, it focuses on helping states identify existing tools, regulations, and programs they can use to facilitate their efforts to address social determinants of health in their individual Medicaid and CHIP programs.

Learn more from the CMS letter “Opportunities in Medicaid and CHIP to Address Social Determinants of Health.”