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.
How State Programs are Defining and Tracking MCO Implementation of APMs
States are utilizing a variety of approaches to require and assess the use of APM strategies through their contracted health plans. Beth Waldman from Bailit Health highlighted findings from a State Health and Value Strategies resource entitled State Medicaid Approaches for Defining and Tracking Managed Care Organizations Implementation of Alternative Payment Models. This webinar highlighted selected approaches and tools used by states to track and assess MCO progress on increasing APMs. Staff from the Rhode Island Office of the Health Insurance Commissioner and Texas Health and Human Services Commission participated to share insights on their APM approaches.