News & Updates

Survey: Medicaid Health Plans Preserved Social Safety Net, Increased Commitment to Health Equity Amid Pandemic

November 18, 2021

Survey: Medicaid Health Plans Preserved Social Safety Net, Increased Commitment To Health Equity Amid Pandemic

Results show strong commitment to community health, declines in value-based purchasing


Washington, DC- As access to medical and social services became significantly more challenging and important for people with Medicaid during the COVID-19 pandemic, a new survey shows Medicaid health plans responded with programs to expand access, address social determinants of health, and prioritize health equity.

Those are some of the findings in the Institute for Medicaid Innovation’s (IMI) 2021 Medicaid Health Plan Survey Report, an annual look at trends shaping Medicaid managed care health plans. Now in its fourth year, the survey offers a comprehensive overview of the value Medicaid managed care contributes to members’ health and the U.S. healthcare system. For example, 95% of Medicaid health plans committed to transition to telehealth in 2020 as the pandemic eliminated or greatly curtailed face-to-face medical appointments, with 70% of health plans paying health care providers the same rate for telehealth and in-person services. A large majority of Medicaid health plans (85%) expanded coverage to new services during the pandemic, such remote behavioral health services and emergency food distribution.

“During the most difficult time in modern history, the health care safety net was stretched to the breaking point but Medicaid health plans kept delivering for many of the most at-risk people in the nation,” said Jennifer Moore, PhD, RN, FAAN, founding executive director of IMI. “The survey results show that Medicaid health plans stretched to accommodate their members, quickly channeling resources where they were needed most.”

Addressing health equity is a priority for Medicaid managed care, according to survey responses. Seven in 10 health plan respondents (70%) reported having a health equity plan. Of those, 100% had a dedicated staff member or team focused on health disparities or related issues. 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.

Other key findings include:

  • Nearly all health plans surveyed (95%) provided targeted services to meet members’ social needs, such as housing supports and food and nutrition services.
  • Nearly all health plans surveyed contracted with community health centers (90%) and worked with community-based organizations to address social needs (95%).
  • A majority of health plans surveyed made direct investments in community capacity building (79%).

The survey shows that use of value-based purchasing systems among Medicaid health plans declined, falling from 92% of plans in 2017 to 75% of plans in 2020.

Communication challenges among patients and providers were frequently cited as an impediment to care. 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).

“Innovations in telehealth, equity, and the social determinants of health have risen to the top of the agenda and become more urgent, and that progress needs to be maintained,” said Nadia Glenn, PhD, MSW, deputy executive director of IMI. “At the same time, more attention is needed for health plans to work with members to coordinate complex care and reward care that is highest quality.”

“Painting a comprehensive portrait of Medicaid managed care offers policymakers and health plans a roadmap for innovation and improvement with implications for all of healthcare,” said Andrea M. Ducas, MPH, senior program officer at the Robert Wood Johnson Foundation, which supported the research. “Understanding how Medicaid health plans served their members during a difficult time holds important lessons for improving people’s health for years to come.”

All Medicaid health plans, including but not limited to members of the Medicaid Health Plans of America and Association for Community Affiliated Plans, were invited to complete IMI’s survey. The results include data from nearly every state with a Medicaid managed care program. IMI’s fourth annual Health Plan Survey provides robust, longitudinal data that helps policymakers and Medicaid health plans identify and respond to key trends to improve care delivery.  


About the Institute for Medicaid Innovation

The Institute for Medicaid Innovation (IMI) is a 501(c)3 nonprofit, nonpartisan research and policy organization that provides independent, nonpartisan information and analysis to inform Medicaid policy and improve the health of the nation.


Media Contact

Sara Matthews