The Affordable Care Act presents Medicaid with significant opportunities to redesign the primary care delivery system to achieve better outcomes and more cost-effective care. In particular, small practices that serve large numbers of Medicaid beneficiaries can benefit f... more
The Affordable Care Act's (ACA) expansion of Medicaid eligibility to 16-20 million new beneficiaries beginning in 2014 could generate unsustainable pressure on Medicaid's already taxed network of primary care providers (PCPs). To encourage broader PCP participation in M... more
The more than nine million individuals enrolled in both Medicare and Medicaid often receive care that is fragmented, poorly coordinated, and high-cost. Integrating their care is difficult because of the challenges associated with aligning the programs' financial incenti... more
Across the country, states are seeking to transform how health care is paid for by shifting from a volume-centric to a value-based payment (VBP) mindset. In June 2015, New York State released A Path Toward Value-Based Payment: Roadmap for Medicaid Payment Reform, outlin... more
Coordinated care organizations (CCOs) are an emerging type of comprehensive managed care program within Medicaid for adults with disabilities and complex chronic illnesses. Yet definitive outcome measures are mostly absent for these complex needs populations. Based on t... more
For states looking to integrate care for duals, a robust stakeholder engagement process will provide invaluable feedback for shaping programs to best meet consumer needs. To help guide states in effectively engaging consumer stakeholders, this technical assistance brief... more
Leading-edge states across the country are exploring the potential of accountable care organizations (ACOs) to drive improvements in quality, delivery, and cost-effectiveness for Medicaid populations. With support from The Commonwealth Fund, and additional funding from ... more
Across the country, robust "super-utilizer" programs providing intensive outpatient care management to high-need, high-cost patients are taking root. The term "super-utilizer" describes individuals whose complex physical, behavioral, and social needs are not well met th... more
The following resources are part of CHCS' Faces of Medicaid analysis, Clarifying Multimorbidity to Improve Targeting and Delivery of Clinical Services for Medicaid Populations, which was undertaken by CHCS and its partners at Johns Hopkins University to examine multimor... more
For more than 40 years, Early and Periodic Screening Diagnostic and Treatment (EPSDT) benefits have provided a critical set of services for Medicaid-enrolled children. With the fiscal pressures on states, the opportunities to enhance EPSDT coverage are significant. T... more
Substantial oral health-related disparities exist across the United States based on race, ethnicity, geography, income, and insurance status, among others. Medicaid ̶ given its size and diversity of enrollees ̶ has significant opportunities to... more
State Medicaid programs are increasingly connecting the dots between the medical, behavioral, and social components of health to achieve the goal of more equitable, whole-person care that addresses the health-related social needs (HRSN) of Medicaid enrollees. Developin... more
