On January 26, 2023, the Centers for Medicare & Medicaid Services approved California’s request to amend the California Advancing and Innovating Medi-Cal Section 1115 demonstration. This expert perspective describes the amendment, a centerpiece of which is approval for California Medicaid to provide a targeted set of Medicaid services to youth and adults in state prisons, county jails, and youth correctional facilities for up to 90 days prior to release. By providing re-entry services to Medicaid-enrolled individuals who are incarcerated, California aims to build a bridge to community-based care for justice-involved enrollees, offering them services to stabilize their physical and behavioral health conditions and establishing, prior to release, a re-entry plan for their community-based care.
Categorizing Value-Based Payment Models According to the LAN Alternative Payment Model Framework: Examples of Payment Models by Category
Megan Burns and Michael Bailit, Bailit Health
As the movement from volume to value-based payment progresses, more state purchasers are requiring their contracted health plans to implement alternative payment models (APMs) with the goals of improving the quality of care and reducing costs for taxpayers. The Health Care Payment Learning and Action Network Alternative Payment Models Framework (the LAN APM Framework) is an increasingly common method being used by states to measure plan progress toward implementation of APMs. While the LAN offers purchasers a guidepost with which to categorize APMs, states still sometimes struggle with their interpretation of the LAN categories. This brief provides real-world examples of APMs within the LAN categories and can help states and other interested purchasers develop a common understanding of what types of payment models fit within the framework categories. The State Health Policy Highlight, Categorizing Value-Based Payment Models According to the LAN Alternative Payment Model Framework, provides a summary of each category for those interested in an overview of APM Framework.
On Wednesday, February 7, State Health and Value Strategies hosted a webinar based on the issue brief that featured real-world examples of what types of payment models fit within the LAN categories.