Media
Developing Primary Care Population-Based Payment Models in Medicaid – A Primer For States
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Implementing Primary Care Value-Based Payment through Medicaid Managed Care
The health care system is increasingly moving away from volume-driven, fee-for-service (FFS) reimbursement and toward value-based payment (VBP) models that incentivize quality, enhance the patient experience, and reduce costs. While VBP is increasingly being adopted in ... more
May 2021
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Advancing Primary Care Innovation through Medicaid Managed Care
As the health care system moves toward more sophisticated value-based payment (VBP) models, those seeking to improve efficiency continue to look to primary care as the key to prevention and better health management. And for good reason: greater use of primary care is as... more
June 2018
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SMD Letter Reaffirms CMS’ Commitment to Value-Based Care and Raises New Questions
On September 15, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director (SMD) letter on value-based care (VBC) opportunities in Medicaid. The letter is designed “to provide information on how states can advance [VBC] across their he... more
September 2020
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Pay for Success: Key Considerations for Gaining Traction in Medicaid
As the Pay for Success movement has grown throughout the United States, a broad array of intermediaries, service providers, and prospective investors have set their sights on state Medicaid programs, which serve one in five Americans, as among the most bankable benefici... more
August 2017
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Identifying and Addressing Health-Related Social Needs Through Primary Care Innovation in Medicaid Managed Care
Social determinants of health — the conditions in which we live, work, and play — are critical drivers of health outcomes. People insured through Medicaid often have unmet health-related social needs that impact their well-being. Medicaid programs have begun to thi... more
September 2021
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Getting Started with Primary Care Population-Based Payment: Four Decision Points for State Medicaid Programs
Payers across the country are launching population-based payment (PBP) models. This upfront, prospective, value-based payment (VBP) approach pays providers based on the number of patients served, as opposed to the number of services performed, and includes provider acc... more
December 2023
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Driving Primary Care Innovation through Medicaid Managed Care: State Approaches
Primary care may finally be getting the attention it deserves. For far too long, the U.S. has spent less than most developed countries on primary care in proportion to other services — between 5 and 7 percent of health care spending — yet, arguably experiences highe... more
September 2019
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We Need More Data on Medicaid ACOs to Determine Drivers of Success
“Provider Payment Reform: Right Course, Wrong Students?,” a recent blog post authored by Chris Koller, President of the Milbank Memorial Fund, argues that while delivering high-value care to vulnerable populations is the “right coursework” for the US health care... more
December 2018
