In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.
Value-based Purchasing for Managed Care Procurements: A Toolkit for State Medicaid Agencies
Mary Beth Dyer and Beth Waldman, Bailit Health
Value-based Purchasing for Managed Care Procurement: A Toolkit for State Medicaid Agencies is designed to assist states interested in implementing value-based purchasing (VBP) approaches with their Medicaid managed care organizations (MCOs). Using a VBP approach can mean significant and ongoing changes for a state Medicaid agency and its MCOs. The Toolkit is designed to guide Medicaid agencies through key action steps and considerations in four phases of the managed care procurement cycle – 1) strategic procurement planning, 2) solicitation development, 3) bidder selection, and 4) contract management.
If you are interested in an overview of the Toolkit and its contents, we have a summary, Purchasing Value in Medicaid Managed Care, that provides a road map for the Toolkit and is an introduction for those interested in learning more about value-based purchasing for managed care.