Survey: Majority of Medicaid managed care plans offered health equity benefits in 2020

Close up of young woman getting online medical help and advice during videocall with doctor checking symptoms
A new survey of Medicaid managed care plans found that 95% are committed to transitioning to telehealth. (master1305/GettyImages)

Seven in 10 health plans said in a recent survey that they offered a plan that aimed to address health inequities over the past year as the pandemic caused plans to stretch resources.

The survey, released Friday by the Institute for Medicaid Innovation, also showed a decline in plans using value-based purchasing systems and noted communication challenges were a major barrier to care.

“The survey results show that Medicaid health plans stretched to accommodate their members, quickly channeling resources where they were needed most,” said Jennifer Moore, founding executive director of the institute, in a statement.

The survey was sent to health plans that participated in Medicaid managed care last year and were a part of one of two leading trade associations for Medicaid plans.

It found that a large majority (95%) gave targeted services to members' social needs that include housing support as well as food and nutrition services.

Another 90% of health plans worked with community health centers, and 95% worked with community-based organizations to treat the social needs of members.

RELATED: OIG: Most states not doing enough to monitor Medicaid telehealth fraud for behavioral health services

The survey also found that 70% of plans have a health equity plan, with all the health equity plans having a dedicated staff member.

“Most respondents said they analyzed how race and ethnicity impacted health outcomes (93%) and quality (80%), and one-third (33%) reported working with Small Disadvantaged Businesses and Small and Diverse Businesses,” according to a release on the survey.

Plans responded that the most frequently targeted social determinants of health programs were for the homeless or housing insecure with 79% and pregnant individuals with 68%.

The insurers also quickly adopted telehealth at the onset of the COVID-19 pandemic when telehealth use exploded as patients were afraid to go to the doctor’s office. The survey found that 95% of plans are committed to transitioning to telehealth, and 85% expanded coverage to new services.

But the survey also found several barriers to care, the top of which was communication among plans and patients.

“The ability to contact members and members’ willingness to engage were the top two barriers reported for high-risk care coordination across all survey years (reported by 100% and 90% respectively in 2020),” a release on the report said.

The survey also showed that fewer plans took advantage of value-based purchasing or alternative payment models, which call for states to hold providers or a plan accountable for meeting cost and quality targets.

In 2020, 75% of Medicaid health plans were involved in such a structure, down by nearly 20 percentage points from the 93% in 2019. The survey also found 15% of respondents said that while they are not in such a structure, they plan to be with the next contract renewal.

The provider type that was most likely to not participate in value-based care were dentists, where 89% of them said they did not engage in a value-based purchasing arrangement. Home- and community-based service providers and long-term care facilities both came in second with 78% of such providers not engaged in value-based care deals.

The results come as the Biden administration has sought for payers and providers to do more to combat health inequities. For instance, the Center for Medicare and Medicaid Innovation has pushed for value-based care models to focus more on health equity.