Improving the quality and cost-effectiveness of publicly financed health care
Medicaid and CHIP Learning Collaboratives
Medicaid and CHIP provide health coverage to nearly 60 million Americans today, and roughly 16 million more individuals will become eligible in 2014 as a result of the Affordable Care Act. It is imperative that state programs ensure that eligible individuals are able to get and keep coverage, and that states purchase cost-effective, high-quality care for beneficiaries. To support the development of high-performing state health coverage programs, the Centers for Medicare & Medicaid Services (CMS) established the Medicaid and CHIP Learning Collaboratives (MAC Collaboratives). These collaboratives are bringing together state and federal partners to address common challenges and pursue innovations in Medicaid program design and operations.
Five collaborative workgroups, each consisting of six to eight states plus federal partners and national experts, will address topics that are critical to establishing a solid health insurance infrastructure:
- Early Innovators in Information Technology: Provide a forum for Early Innovator states to explore key issues that they face in launching exchanges, while creating tools and artifacts to share with all states seeking to establish exchanges.
- Expanding Coverage: Enable states to understand new federal rules and effectively design eligibility and enrollment policies and procedures as well as benefit structures to fulfill requirements.
- Data Analytics: Encourage states to consider the most effective approaches for using data analytics to support program operations.
- Promoting Efficient and Effective IT Practices: Enable states to design and efficiently develop information technology infrastructure that supports high-performing Medicaid programs, reducing the total cost of ownership, project risk, and cycle time for new products and capabilities while improving business results.
- Value-Based Purchasing: Focus on building and financing the next generation of: (1) enhanced primary care case management and fee-for-service models; and (2) managed care organization contracting models.
Each collaborative will meet regularly in 2012 to develop new solutions for advancing high-performing state health coverage programs. By developing new strategies, testing ideas and collaboratively crafting solutions in a shared learning environment, these learning collaboratives will generate practical and actionable results that will be disseminated nationally.
Learning Collaborative Team
The MAC Collaboratives activities are coordinated by Mathematica Policy Research, the Center for Health Care Strategies, and Manatt Health Solutions, with additional assistance from external experts and in close association with CMS.