State Medicaid Care Coordination & Value-Based Payment Initiatives: An OPEN MINDS Reference Guide
The passage of the Patient Protection and Affordable Care Act (PPACA) of 2010 has resulted in an increase in the number of state Medicaid programs implementing care coordination and value-based payment initiatives – with the goal of improving the quality of consumer care and bending the health care cost curve. While some of these initiatives, such as health homes, were created by, or because of, the PPACA, others have risen organically out of the need to lower costs and improve care, such as state Medicaid managed care contracts that require the use of alternative payment models for provider organizations.
This OPEN MINDS Reference Guide catalogs the current and future use of the ten most significant Medicaid care coordination and value-based payment initiatives in every state. These ten initiatives include:
- Alternative payment model (APM) requirements in managed care organizations (MCO) contracts
- Accountable care organizations (ACOs)
- Specialty consumer health plans
- Health homes
- Patient-centered medical homes (PCMH)
- Dual eligible demonstration
- Delivery system reform incentive payment (DSRIP) program
- Managed long-term services and supports (MLTSS)
- State Innovation Model (SIM) grants
- Certified Community Behavioral Health Clinics (CCBHC) demonstration