States' Use Of Medicaid Managed Care 'In Lieu Of Services' Authority To Address Poor Nutrition

In response to rising health, economic, and equity burdens of suboptimal nutrition, health care stakeholders are increasingly integrating nutritional supports into health care delivery and financing. In January 2023, federal guidance clarified that states may use "in lieu of services and settin...

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Bibliographic Details
Published in:Health affairs (Millwood, Va.) Vol. 44; no. 4; p. 422
Main Authors: Garfield, Kathryn, Hanson, Erika, Shachar, Carmel, Stain, Pascale, Mozaffarian, Dariush
Format: Journal Article
Language:English
Published: United States 01.04.2025
Subjects:
Health Policy
Humans
Managed Care Programs - economics
Managed Care Programs - organization & administration
Managed Care Programs - statistics & numerical data
Medicaid - statistics & numerical data
United States
United States
ISSN:2694-233X, 2694-233X
Online Access:Get more information
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Summary:In response to rising health, economic, and equity burdens of suboptimal nutrition, health care stakeholders are increasingly integrating nutritional supports into health care delivery and financing. In January 2023, federal guidance clarified that states may use "in lieu of services and settings" (ILOS) authority to address health-related social needs, including nutrition, in Medicaid managed care. However, few data are available regarding ILOS implementation. This analysis reviewed ILOS policies based on managed care documents from forty states as of October 1, 2024. Thirty-five states have authorized ILOS to address behavioral health, and fourteen states have authorized ILOS to address general medical needs. Twelve states use ILOS to address health-related social needs; of these, only ten address nutrition. In addition, fewer than half of the forty states provide robust guidance regarding evaluation or establishment of new ILOSs. We examine the policy implications of these findings and provide recommendations to strengthen the role of ILOS in improving nutrition, health care costs, and health equity.
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ISSN:2694-233X
2694-233X
DOI:10.1377/hlthaff.2024.01349