摘要：Objectives. To critically analyze social work’s role in Medicaid reform.
Methods. We conducted semistructured interviews with 46 stakeholders from 10 US
states that use a range of Medicaid reform approaches. We identified participants using
snowball and purposive sampling. We gathered data in 2016 and analyzed them using
qualitative methods.
Results. Multiple themes emerged: (1) social work participates in Medicaid reform
through clinical practice, including care coordination and case management; (2) there is
a gap between social work’s practice-level and systems-level involvement in Medicaid
innovations; (3) factors hindering social work’s involvement in systems-level practice
include lack of visibility, insufficient clarity on social work’s role and impact, and too few
resources within professional organizations; and (4) social workers need more training in
health transformation payment models and policy.
Conclusions. Social workers have unique skills that are valuable to building health
systems that promote population health and reduce health inequities. Although there is
considerable opportunity for social work to increase its role in Medicaid reform, there is
little social work involvement at the systems level.
