Implementing the Social Need Screening and Intervention (SNS‑E) HEDIS® measure requires more than selecting an approved screening tool—it demands operational accountability, audit‑ready documentation, and effective follow‑through on identified needs. This session presents a real‑world case study of how Kentucky Medicaid managed care organizations partnered with a full‑risk provider to operationalize SNS‑E at scale by aligning financial accountability, care delivery, and quality strategy. Attendees will learn how shared risk arrangements enabled disciplined workflows for screening, intervention, documentation, and supplemental data reporting.

The session highlights how non‑traditional care delivery models—including community‑based and street‑level engagement—supported reach into populations often missed by clinic‑based approaches, while maintaining fidelity to HEDIS requirements. Speakers will walk through the operational design behind closed‑loop interventions, standardized reporting, and data exchange processes that allowed plans to confidently incorporate supplemental data into HEDIS and audit workflows. This session also offers practical insights for Medicaid quality, population health, and accreditation leaders seeking to move SNS‑E from a compliance exercise to a measurable driver of quality performance, health equity, and value‑based care outcomes.

Key Takeaways:

• SNS‑E success is driven by intentional payer–provider collaboration, not standalone provider activity. Effective SNS‑E implementation requires alignment between managed care organizations and providers around workflows, expectations, and roles—ensuring that screening, intervention, and follow‑through are embedded into the plan’s broader quality strategy rather than treated as a siloed provider function.
• Full‑risk models enable providers to operate beyond billable codes to support quality outcomes. Shared financial accountability allows providers to deploy non‑traditional, community‑based resources—such as sustained outreach and in‑home or street‑level engagement—that directly support social need intervention and quality performance without being constrained by visit‑based reimbursement structures.
• Aligned data sharing and reporting processes strengthen SNS‑E performance at scale. When payers and full‑risk providers collaborate on data standards, reporting cadence, and integration of supplemental data, SNS‑E becomes a coordinated quality initiative that supports consistent performance, improved member reach, and advancement of health equity across the managed care population.