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States may choose to contract with Managed Care Organizations (MCOs) to provide Medicaid services and benefits to certain eligible populations. MCOs must provide all required Medicaid benefits, but may also choose to provide additional benefits, such as social services, in order to reduce the cost and to improve the quality of care. Such services are referred to as value-added services, and may be offered if authorized through the MCO’s contract, however the cost of the services may not be calculated into the capitation rate.States may also use the MCO contracting process to require MCOs to perform certain activities, like using health risk assessments to also assess whole person needs.

Example:

Michigan

The Michigan Department of Health and Human Services (DHHS) incorporated the collection and use of data on social determinants of health as a responsibility of its Medicaid health plans in the 2016 contract. Plans must “develop a multi-year plan to incorporate social determinants of health into their process for analyzing data to support population health management.” DHHS also requires contractors to develop a “core set of social determinants of health” as part of their provider performance measure reports