As states look to expand and sustain community violence intervention efforts, Medicaid is emerging as a promising funding source for both hospital-based and community-based violence intervention initiatives. A new guide published by the Health Alliance for Violence Intervention, or HAVI, outlines how states, counties, healthcare systems, and community organizations can use Medicaid to fund violence prevention services and build long-term sustainability for the field. The report draws on more than a decade of HAVI’s work shaping Medicaid policy and examines the pathways states can use to establish violence prevention benefits, as well as implementation lessons from states that have already done so. As the report explains, its goal is to “equip all violence prevention stakeholders with the knowledge needed to build and sustain Medicaid-funded services for the people at greatest risk of experiencing community violence.” The full report is worth your time, but here are some toplines:
- Medicaid Is A Growing Funding Source For Violence Intervention Programs. Researchers note that “states [are] increasingly turning to Medicaid to support sustainable, evidence-based violence intervention strategies” and argue that “integrating Medicaid policy into public health solutions is crucial to reducing violence and enhancing community safety.” The report also points out that Medicaid already bears much of the financial burden associated with firearm injuries, noting that between 2016 and 2021 firearm injury hospitalizations cost nearly $8 billion, with Medicaid covering approximately $4 billion.
- Eight States Have Already Created Violence Prevention Benefits. According to the report, states can establish violence prevention benefits through “existing mandatory and optional state plan benefits, as well as … other waivers.” In many cases, “a benefit can often be added without passing new legislation if the state Medicaid agency has the authority to create a benefit under existing law,” allowing state officials to establish coverage through the State Plan Amendment process. The report notes that eight states—California, Connecticut, Colorado, Illinois, Maryland, Michigan, New York, and Oregon—have already successfully added violence prevention benefits through legislation, benefit modifications, or state plan amendments.
- The Importance Of Bringing Providers To The Table Early. The report emphasizes that “collaboration is critical for designing a strong and accessible Medicaid violence prevention benefit” and recommends creating a working group that includes “violence prevention experts, Medicaid administrators, health care providers, and community-based organizations.” The group should address practical implementation issues including training and certification standards, billable activities, reimbursement structures, startup funding, and provider billing codes. HAVI also recommends that states recognize multiple certifying organizations to ensure that training aligns with both hospital-based and community-based violence intervention models.
