Over the past decade, Medicaid programs have been transitioning from fee-for-service provider payment to value-based payment models. Some states are now taking the next step by adopting more advanced arrangements that can accelerate primary care transformation efforts ... more
[su_note] Texas Key Facts State Population: 30.5 million Medicaid Enrollees: 5.7 million Enrollees with Diabetes: 187,000 Medicaid Spending on Diabetes: $18.9 billion [/su_note] Access to continuous glucose monitors (CGMs) in the U.S. has been limi... more
Pharmacists play an essential role in the health care ecosystem. They facilitate medication management, educate patients, provide vaccinations, and engage in public health promotion initiatives. They are also among the most familiar and accessible health care professio... more
In many state Medicaid programs, primary care is the keystone that supports other state health care priorities, like value-based care and health equity. Better primary care is associated with improved health outcomes, lower health care costs, and reductions in health di... more
In new procurements and contracts, state Medicaid agencies are expecting more from Medicaid managed care organizations (MCOs), and are increasing requirements that promote primary care innovation, health equity, and community engagement. To meet these requirements, MCO... more
Having a specialist as your primary care physician (PCP) may seem unconventional, but for many individuals with disabilities, it is a practical and often necessary choice. In fact, some state Medicaid agencies and health plans have long-standing policies allowing speci... more
Value-based payment (VBP) — provider payment models that shift from volume-based fee-for-service (FFS) to support value-driven care delivery — is an important strategy for states seeking to promote innovative primary care approaches through Medicaid managed care. To... more
Health Quality Partners, based in Southeastern Pennsylvania, created the Advanced Preventive Care (APC) model for chronically ill older adults. This multi-faceted model uses specially trained community-based nurses to improve the overall quality of life and health outc... more
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