Medicaid Health Plans Are Expanding Social Care Benefits: How Our Social Needs Screener Helps Members Qualify
Across the United States, Medicaid health plans are expanding coverage for social care benefitsthat address the social drivers of health (SDOH). These include housing instability, food insecurity, transportation barriers, and utility challenges. These non-medical Medicaid benefitsplay an important role in improving health outcomes, supporting equity, and reducing avoidable healthcare costs.
For Medicaid payors and managed care organizations (MCOs), success requires more than offering these services. Health plans must identify social needs early and connect eligible members to the right benefits at the right time. This makes social needs screening for Medicaid a critical part of any social care strategy.
Learn more about how Care Compass Health supports this work at
Why Social Care Benefits Are Growing Across Medicaid Programs
State Medicaid programs and Medicaid managed care organizations now recognize that unmet social needs often lead to higher costs and worse health outcomes. Issues like unstable housing, lack of food, and missed transportation can cause members to miss appointments, struggle with medications, and rely more on emergency care.
In March 2025, the Centers for Medicare & Medicaid Services (CMS) updated its guidance on social care services in Medicaid. Instead of broad approvals, CMS now reviews services such as housing support and nutrition assistance on a case-by-case basis. These reviews happen through Section 1115 waivers and state plan amendments (SPAs). This approach gives states more flexibility, but it also requires strong data, clear documentation, and proof of impact.
At the same time, CMS continues to reinforce social drivers of health screening requirements as part of care planning, quality reporting, and value-based care programs. For Medicaid health plans, identifying social risk is no longer optional. It is a core part of program success.
What Social Care Benefits Look Like in Medicaid Today
Depending on the state and waiver design, Medicaid social care benefits may include:
- Temporary housing assistance or help with housing-related costs
- Meal delivery, medically tailored meals, or food vouchers to address food insecurity
- Non-emergency medical transportation (NEMT) and other non-medical rides
- Utility assistance tied to medical needs or medical equipment
- Referrals to community-based social services, often supported by community health workers (CHWs)
Because these benefits are needs-based, eligibility depends on accurate and consistent social risk screening for Medicaid members.
How Our Social Needs Screener Helps Medicaid Health Plans Qualify Members for Benefits
1. Identifies Social Drivers of Health Clearly and Respectfully
Many Medicaid members do not share social challenges unless they are asked directly and respectfully. Our SDOH screening tool for Medicaid plans helps identify common barriers, including:
- Food insecurity
- Trouble paying utility bills
- Unsafe or unstable housing
- Lack of reliable transportation
By using a consistent screening approach, health plans gain a clearer view of social risk across their member populations.
Learn more about Care Compass Health’s approach to identifying social needs:
2. Matches Identified Needs to Available Medicaid Social Care Benefits
Screening results help Medicaid care teams understand which members may qualify for specific services. For example:
- Members with housing instability may qualify for housing-related supports under a waiver
- Members without transportation may qualify for non-medical rides or NEMT services
This targeted process helps ensure Medicaid social care benefits are used as intended and reach members who need them most.
3. Supports Care Teams, Care Planning, and Follow-Through
Our screener creates structured, easy-to-use data that allows Medicaid health plans to:
- Focus on the most urgent social needs
- Include social needs in shared care plans
- Track services and outcomes over time
This turns social needs screening in Medicaid into a practical tool for care coordination and population health management, not just a compliance task.
4. Advances Quality, Equity, and Value-Based Care Goals
Addressing social drivers of health is a key part of value-based care in Medicaid. Health plans that use social needs data effectively can:
- Improve outcomes for high-risk and vulnerable members
- Reduce avoidable hospital and emergency department visits
- Identify gaps in care and support health equity efforts
- Improve performance on Medicaid quality measures
For Medicaid payors, this leads to stronger programs, better use of benefits, and healthier member populations.
Frequently Asked Questions
What are social care benefits in Medicaid?
Social care benefits in Medicaid are non-medical services that address social drivers of health. These include housing support, food assistance, transportation services, and help with utilities. These benefits are often offered through Section 1115 waivers or state plan amendments.
Are Medicaid health plans required to screen for social drivers of health?
CMS continues to emphasize SDOH screening requirements as part of care planning, quality reporting, and value-based care programs. While requirements vary by state, most Medicaid programs expect health plans to identify and respond to social risk.
How do Medicaid plans determine eligibility for social care benefits?
Eligibility is usually needs-based and informed by social needs screening tools, member assessments, and state-specific waiver rules. Accurate screening is the first step to connecting members with the right services.
How do social care benefits impact Medicaid costs and outcomes?
Addressing social drivers of health can reduce missed appointments, improve medication use, and lower avoidable hospital visits. This leads to better outcomes and lower total cost of care for Medicaid health plans.
What role do screening tools play in Medicaid social care programs?
Screening tools help standardize how social risk is identified, connect members to services, support care coordination, and provide data needed for CMS reporting, quality measurement, and program evaluation.