Funder: Center for Medicare & Medicaid Innovation

Author: Tricia Leddy, Tricia McGinnis, and Greg Howe, Center for Health Care Strategies

February 2016 | Brief


With over half of all Medicaid beneficiaries receiving services through managed care organizations (MCOs), states have a unique opportunity to use MCO contracts and relationships to accelerate wide-scale adoption of value-based payment (VBP) at the provider level.

This brief draws on experiences from seven state Medicaid agencies — Arizona, Minnesota, New Mexico, New York, Pennsylvania, South Carolina, and Tennessee — that have used MCO contract requirements and request for proposals (RFPs) to advance value-based payment goals. It outlines five practical approaches for promoting VBP goals through MCO contracts and provides guidance for developing RFP questions to assess MCO interest in and experience with VBP.

This resource was developed with support from the Center for Medicare and Medicaid Innovation as part of a team led by NORC at the University of Chicago, which is serving as the State Innovation Model Resource Support Contractor.