Issue Briefs | Apr 25, 2017

State Strategies: Value-Based Payment for Medicaid Populations with Complex Care Needs

 Erin Taylor, Mary Beth Dyer and Michael Bailit, Bailit Health

Driven to improve care coordination and contain costs by moving away from a volume-based payment model, an increasing number of states are implementing risk-based managed care programs to deliver long-term services and supports (LTSS). As the primary payer for LTSS, state Medicaid programs have a significant interest in ensuring that entities with which they contract deliver high quality and cost-effective care to members. This issue brief identifies ways states can learn from value-based payment models being applied elsewhere to create more accountability for the quality and cost of LTSS.


Expert Perspectives

CMS Offers New Details on Account Transfer 2.0

The Center for Medicaid and CHIP Services (CMCS) explained the transition to “Account Transfer 2.0” (AT 2.0) in a CMCS Informational Bulletin (CIB) released on October 10, 2024. The CIB indicates significant federal investment in improving the process of transferring consumer application information between state Medicaid and CHIP agencies and the Marketplace in the states using the federal platform. This expert perspective reviews the CIB and highlights opportunities for states to improve account transfer data under the CIB.

CMS Solicits Comments on Medicaid/CHIP Reporting Templates for Mental Health and Substance Use Disorder Parity

On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.