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Community Investments in West Virginia through Medicaid Managed Care

February 2023
Full report

Medicaid managed care plans work to improve clinical and non-clinical factors that contribute to the health and wellbeing of Medicaid members and their communities. Plans are well situated to improve the whole health of individuals, making them an important partner in investing in under-resourced communities.

In 2021, West Virginia’s Bureau for Medical Services (BMS) modified its Medicaid managed care contracts to allow health plans to develop strategies to address Social Drivers of Health (SDOH) and include spending for those strategies in the Medical Loss Ratio (MLR) numerator.

This brief provides an example of how UniCare Health Plan of West Virginia, an Elevance Health affiliated Medicaid plan, leveraged the SDOH MLR contract changes to maximize its community investments. Those changes eliminated a significant barrier for managed care plans in West Virginia to invest in whole health. Policymakers could consider various options to amend MLR requirements to support increased investment in SDOH-related activities.


  • Medicaid Managed Care 
  • Social Drivers of Health (SDOH)
  • SDOH and the Medical Loss Ratio
  • Community Investments in West Virginia
  • Policy Recommendations

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