As of July 1st, North Caroline shifted to a Medicaid Managed Care Program. Almost 1.6 million beneficiaries are now receiving the same care in a new way through Medicaid Managed Care health plans.
Wisconsin’s long-tenured Family Care MLTSS Program continues to find success with major goals including increased ability to keep consumers at home, lowered costs and reduced inefficiencies. They continue to raise the bar for national MLTSS programs.
Tennessee has built a strong structure for their Medicaid-managed long-term services and supports community with a program they launched in 2010 called CHOICES. Their program has been revered for its flexibility, high quality, and consumer-first approach.
Iowa’s IA Health Link launch left both providers and consumers frustrated by putting their budget before the quality of care. We analyze the missteps they took after setting unrealistic timelines for the work that needed to be done. Their MLTSS program continues to serve as a learning tool for other state’s roll outs.
First up in our review of value-based purchasing in managed care MLTSS programs is Arizona. The program has gone through a variety of upgrades and changes.
Value-Based Payments Growth Trends…Are You Ready? THE VBP Blog We are exploring value-based growth trends this week. Current data shows Medicaid managed care programs using value-based payments programs have experienced steady growth over the past few years, 67% of Medicaid’s 74 million consumers are enrolled in some type of health plan and 55% of Medicaid budgets are going to health plan payments. Of all Medicaid MCO respondents, 93% utilized a value-based purchasing (VBP) or alternative payment model (APM), according to a survey done in 2020 by Medicaid Innovation. That is an increase of 14% since 2017. The survey covered 2019 data taken from Medicaid managed care organizations (MCOs), and the trend continues Enrollment Growth Trends Enrollment also continues to climb,… Read More »Value-Based Payments Growth Trends…. Are You Ready?
Four Pillars to Build On in a VBP Environment THE VBP Blog [1/14/2021] In 2020, we took on the monumental task of evaluating all ten states that offered managed care programs for the Intellectual and Developmental Disabilities (I/DD) population. In our final blog of that series, we broke down our findings into four main pillars. These frameworks provided structure across the many different approaches over the ten states. At the end of 2020, we offered our commitments as a company and in this blog we take a look at how those cross over. 4 Pillars of Reviewing Value-Based Care in I/DD Managed Care Time Matters: more than almost any other factor, the states that gave themselves time for a methodical… Read More »The Four Pillars to Build On in a VBP Environment
The Primary Care First VBP Model Explained THE VBP Blog [12/17/20] The Primary Care First (PCF) model was established by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. It offers a regionally-based, multi-payer approach to primary delivery and payment. By design, PCF allows for increased flexibility and freedom for practitioners to be innovative in their approach to increase quality and reduce costs. PCF will be offered in 26 regions in 2021, including many that were covered in our I/DD Managed Care Review blogs. In those blogs, we covered the ten current programs being offered. Out of those ten, five (New York, Tennessee, Kansas, Arkansas, and Michigan) also have a PCF option. This leaves us hopeful that PCF programs… Read More »The Primary Care First Model Explained