State Medicaid Approaches for Defining and Tracking Managed Care Organizations Implementation of Alternative Payment Models
Beth Waldman, Michael Bailit and Mary Beth Dyer, Bailit Health
As state Medicaid programs emphasize a focus on value-based payment, they are increasingly requiring their Medicaid managed care organizations to implement alternative payment methodologies (APMs). With these new requirements, it is important for states to develop ways to ensure that their MCOs are complying with the APM requirements within their contract, and monitoring the progress and challenges with the implementation of APM strategies with Medicaid providers. The full brief focuses on different ways in which states may set standard APM definitions to a) track MCO progress toward meeting state APM goals, and b) support comparison of APM implementation within a state and nationally. The State Health Policy Highlight, Defining and Tracking Managed Care Organizations Implementation of Alternative Payment Models, summarizes the strengths and challenges of different approaches to setting APM definitions, for those interested in a high-level overview of the operational issues involved.
On Wednesday, February 14, State Health and Value Strategies hosted a webinar based on the issue brief that highlighted selected approaches and tools used by states to track and assess MCO progress on increasing APMs
As the United States enters its seventh month of the COVID-19 vaccine rollout, available data show distribution efforts have not produced equitable outcomes. This expert perspective details how state leaders can use administrative, policy, and funding levers to support community partners in improving access points, addressing structural barriers to vaccination, and establishing rapid data collection and evaluation efforts for equitable COVID-19 vaccine distribution solutions.
With the passage of the American Rescue Plan (ARP), more people than ever before are eligible for financial help to pay for a health insurance plan. Estimates are that on average, 4 out of 5 customers can now find a health plan for less than $10 a month—a remarkable step to provide more affordable coverage, for more Americans. To promote these significant savings, Marketplaces are launching integrated and innovative outreach campaigns—including tapping into existing public health and COVID-19 vaccination efforts—to reach residents with this important information and get them enrolled. As vaccine distribution is increasingly going local, state marketplaces are tapping into trusted partners like local community centers, faith groups, and small businesses as well as coordinating with state and federal agencies to combine education and outreach to drive enrollment. As Marketplaces look for ways to ensure equitable outreach and enrollment, especially as our nation recovers from COVID-19, this expert perspective highlights a range of communications and outreach strategies to align with vaccine education and distribution.
The rollout of vaccines designed to end the coronavirus (COVID-19) crisis has begun in earnest across the United States. Currently, each state is responsible for determining how to allocate, distribute, track, and report its vaccine allotment from the federal government, although the federal government is expected to take on a larger role under a new Biden administration. Since the beginning of the pandemic, Black, Indigenous, and other people of color have been disproportionately impacted by both higher risks of infection and poorer health outcomes, and many are concerned that an inequitable or inefficient distribution of the COVID-19 vaccine may further widen health inequities among these populations. One way to help ensure the equitable administration of COVID-19 vaccine is to track vaccine administration disaggregated for key subpopulations, such as gender, race and ethnicity, and geography (e.g., urban vs. rural). This expert perspective reviews the data states are currently publicly reporting related to vaccine administration and provides an interactive map that explores the extent to which all 50 states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography. The expert perspective also discusses what current data sources states are using to provide this information and provides an overview of options states can consider to collect information about the administration of COVID-19 vaccine in populations via survey data.