Medicaid and other payers are recognizing that health outcomes and costs are driven by factors beyond clinical care. These factors are rooted in the community and include issues such as housing, food security, transportation, and the neighborhood environment in which people live, learn, play, pray, and work. Through an initiative sponsored by the Robert Wood Johnson Foundation, Payment Reform for Population Health, AcademyHealth partnered with the Nemours Children’s Health System to work with Maryland, Oregon, and Washington State to address the payment challenge. Specifically, they worked with states to explore current Medicaid authorities to promote and provide prevention services in community settings, cover upstream prevention benefits such as assessing a home for asthma triggers, and deliver services using nontraditional community-based providers.
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