Managed Care Reduces Nursing Home Populations, But Low-Need Residents Remain
A recent study shows managed care reduces overall nursing home use but fails to transition low-need residents into less restrictive long-term care settings.
Medicaid
Unplanned Long-Term Care Costs Threaten U.S. Retirement Security
New analysis warns that long-term care expenses pose serious risks to retirement security, particularly for single women and Baby Boomers.
New York Expands Behavioral Health Access Through Medicaid Reforms
New York announces improved Medicaid managed care compliance for behavioral health services despite weakening federal enforcement on mental health parity.
Idaho Plans Full Transition to Medicaid Managed Care by 2029
Idaho plans to shift all Medicaid services to private managed care by 2029, with health officials cautioning the transition must be gradual to avoid disruption.
New York Awards Contracts for In-Home Assistive Technology to Support Independent Living for People with I/DD
New York’s OPWDD has awarded contracts to eight providers to deliver assistive technologies and supports that promote independence for people with intellectual and developmental disabilities.
CMS Moves to Rein In Medicaid Spending on Programs Not Directly Tied to Healthcare Services
CMS announced it will stop approving Medicaid matching funds for state programs not directly linked to healthcare, aiming to preserve the integrity of the Medicaid partnership.
Driving Better Outcomes – How Value-Based Payments Advance Florida’s Medicaid Managed Care Program
Florida’s SMMC 3.0 program places a strong emphasis on value-based purchasing, rewarding providers for quality and cost-effective care. This shift is central to improving outcomes and ensuring Medicaid recipients receive better, more coordinated services.
Category: Healthcare Payers
Pennsylvania Reduces IDD Emergency Waiting List, Expands Home and Community-Based Services
The Shapiro Administration cut Pennsylvania’s IDD emergency waiting list by 19% and enrolled 3,000+ individuals in services, supported by major budget investments in the 2024-25 fiscal year.
Florida’s SMMC 3.0 Aims to Advance Medicaid Managed Care In The State
Florida’s Statewide Medicaid Managed Care (SMMC) 3.0 program, launched on February 1, 2025, introduces significant enhancements aimed at improving care coordination, integrating behavioral analysis services, and piloting managed care for individuals with intellectual and developmental disabilities.
Illinois Awards $12 Billion in D-SNP Contracts to Four Health Plans
Illinois has awarded $12 billion in contracts to four health plans as it transitions to a fully integrated D-SNP model for dual-eligible beneficiaries beginning in 2026.