On Wednesday, August 22, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter (SMDL) memorializing CMS policy for ensuring that Section 1115 waivers remain budget neutral to the federal government. The SMDL describes CMS policy for calculating budget neutrality both for new waivers and for extensions of existing waivers with the implications for states with existing waivers, and those seeking to apply for waivers, discussed in this expert perspective.
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.