CHCS worked with the state of Indiana to incorporate a value-based purchasing focus into its Medicaid managed care programs. The state set consistent quality improvement standards for its health plans by including the BCAP Quality Framework in its plan procurement requirements as the preferred quality improvement approach. CHCS technical assistance also helped the state to develop value-based purchasing tools, including monitoring and incentive payments.

In 2005, the state used the BCAP Quality Framework to help Medicaid health plans integrate with the Indiana Chronic Disease Management Program, which was designed to improve the quality of health care for people living with asthma, diabetes, and congestive heart failure. CHCS and the McColl Institute for Health Care Innovation worked together with Indiana Medicaid staff, health plan leadership, and local physicians to implement a sustainable model of care for people with these three chronic conditions.