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February 20th, 2018

During the first year of the Trump administration, states have grappled with many unanswered questions regarding the new administration’s views on value-based payments (VBPs) and how it would approach state-led or Medicaid based payment reform initiatives. These include to what extent existing efforts will continue to be supported or renewed, what mechanisms states can or should use to implement VBPs (e.g., DSRIP programs, 1115 waivers, 1115A waivers), what financial support will be available, and how much flexibility the Center for Medicare & Medicaid Services (CMS) will grant states in designing and funding innovative models. In the past eight months, CMS has revealed what it will look for in these initiatives moving forward, such as a desire to support state innovation. This paper provides a historical perspective on VBPs, including the health care system’s move away from payment models based on fee-for-service, and an overview of state models focused on value and quality. The paper also outlines the Trump administration’s key signals to date and how they might impact state VBP efforts in 2018 and beyond.

May 1st, 2017

The Affordable Care Act turned Medicaid into America’s largest public health care coverage program. While the volume associated with this growing program created increasing opportunities for providers, health systems, health plans, and vendors, these same stakeholders shouldn’t write off opportunities in Medicaid now simply because of the change in direction at the federal level. Instead, […]

September 1st, 2016

Not Losing Sight of the Dual Eligible in the Move to Value Based Payments Value-based payments arrangements are increasing. While most of this movement is being driven through Medicare-based payment initiatives, CMS is now increasingly pushing value-based payments in Medicaid based on the success CMS has achieved in Medicare. The shift to value-based payments is […]

April 24th, 2014

The Basic Health Program (BHP) provides flexibility to states to design a health coverage option to better meet the needs of their low-income population.

April 3rd, 2014

Laura Summers and Michael Deily were quoted in an AISHealth article on the increasing number of Republican-controlled states that are reconsidering their opposition to Medicaid expansion under the Affordable Care Act (ACA).

October 24th, 2013

What works and 8 lessons other health care organizations learn

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