Across the country, Medicaid health plans are deepening their investments in community health strategies to better support their members. Yet we need to ask: Are these initiatives truly shaped by the voices of the communities they intend to serve? Traditional community health assessments often miss the mark. They may capture the data, but not the story—overlooking the lived experiences, priorities, and challenges that shape health outcomes. Without genuine community engagement, well-intentioned strategies can fail to resonate, leading to low participation, limited impact, and unrealized return on investment.
Our team at Activate Care approaches this challenge differently. Our mission is to elevate community voice at every stage of the process—translating that input into actionable insights that drive measurable improvement in health, equity, and financial performance. By applying Community-Engaged Research (CER) methods, grounded in the principles of Community-Based Participatory Research (CBPR), we help health plans move beyond surface-level data toward a deeper, systems-level and community-informed understanding of what truly drives health and wellbeing.
From Data to Action: A Case Study in Nevada
In our recent collaboration with a Managed Care Organization (MCO) in Nevada, we applied CBPR principles to conduct a mixed-methods assessment across both urban and rural communities. From the outset, we prioritized equitable, inclusive engagement to ensure the process reflected the voices of those most affected by health inequities. This included close collaboration with local, trusted community-based organizations (CBOs) to co-host focus groups in familiar, accessible settings—spaces where participants felt comfortable sharing their experiences openly. Our Community Advisory Council (CAC) played an active role not only in shaping the research design but also in supporting recruitment efforts, helping us reach a broad and diverse group of participants representing varied lived experiences and perspectives, and in disseminating the findings.
To further reduce barriers to participation, we offered childcare support, transportation stipends, and flexible participation options, including both virtual and in-person sessions. These steps helped ensure that engagement was not only broad but equitable—welcoming those who are often excluded from traditional assessment processes due to logistical, financial, or trust-related barriers. The result was a richer, more authentic understanding of community needs and priorities, grounded in genuine partnership and mutual respect.
The outcome was more than just a report—it was a roadmap for change. The findings informed population health initiatives, refined care management strategies, and guided targeted investments in community-based organizations. Most importantly, the process itself strengthened trust and transparency between the plan and the communities it serves.
Leveraging Community Engagement to Drive ROI
When health plans authentically engage communities, they gain more than qualitative insights—they gain actionable intelligence that drives better outcomes. Community-informed strategies can:
- Improve member engagement and satisfaction
- Enhance quality and performance measures
- Reduce avoidable utilization and associated costs
- Guide more effective interventions
- Strengthen equity and trust within the communities served
For example, our community engagement strategies and garnered insights guided the creation and delivery of our CHW-led social needs intervention, which we have deployed in several states. We find that a CHW workforce program equipped with community-driven insights can better support the individuals and families served, and lead to cost savings. For example, we saved a health plan in the Mountain West region $1.79 for every $1 invested in a program that supplemented traditional care management with social support from CHWs working alongside a clinically focused case manager. CHWs also supported engagement with hard-to-reach members, saving the same health plan $1.47 per $1 invested to connect members with the case management program for the first time. These results are based on a 6-month pre-post comparison of total cost of care and are derived from medical claims for individuals who enrolled within the first 50 days of program implementation. We expect the final estimated ROI to be even higher as the program progresses, but these early results are promising and underscore how a highly informed, community-connected, and locally based CHW workforce can yield significant economic benefits.
Ultimately, embedding the community’s voice isn’t just the right thing to do—it’s the smart thing to do. By designing benefits, programs, and investments that reflect real-world needs and strengths, Medicaid plans can achieve measurable returns while advancing health equity across their member populations.
Interested in learning more about how Activate Care can support your community-engaged research or interventions? Click here to learn more.