In this talk, Nicholas Duran, Executive Director from CVS Health/Aetna, focused on the evolving landscape of Medicaid, highlighting the importance of understanding social determinants of health (SDoH) and/or health related social needs. The discussion emphasized the significance of engaging stakeholders—including community organizations and providers—to better serve Medicaid populations and the need to consider diverse perspectives from state departments of health and government offices.

The Medicaid program typically operates with a 60/40 federal-to-state funding split, but there is significant variation in how each state manages its program. Health plans, such as Aetna, monitor state trends and adapt accordingly. Mr. Duran emphasized that current state priorities include comprehensive care coordination, population health management with substantial investment, and a strong focus on addressing health-related social needs like housing and food insecurity.

He also shared how plans are leveraging analytics and on-the-ground qualitative data collection to guide investments and provide value-added benefits, such as gift certificates for clothing and food delivery. The importance of sharing opportunities without overburdening providers was highlighted, especially as resources may become more limited.

Key takeaways from this session include:

• Learn about a strategy to navigate the pending changes in Medicaid funding
• Learn how payers are engaging diverse stakeholder to serve the Medicaid population
• Learn how payers and states continue to focus on the social determinants of health in Medicare
• Identify the various variable influencing state approaches to Medicaid