In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.
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.