15 May HCTTF Congressional Briefing: Pursuing Value in Medicaid
Pursuing Value in Medicaid: States as Transformation Leaders
States are critical partners in transitioning health care away from fee-for-service to value-based payments that focus on lowering cost, improving the quality of care, and producing better population health. The Medicare Access and CHIP Reauthorization Act of 2015 set a clear path for Medicare to transition more payments to alternative payment models under the Quality Payment Program. However, state Medicaid programs also serve as important and complementary laboratories for testing health care innovation and identifying effective strategies to support an effective and sustainable transformation of the overall delivery system.
Over 80 people gathered to hear directly from a panel of experts about how State Medicaid programs are innovating to improve health care quality, lower costs, and give providers the flexibility to better care for patients with complex needs. You can find the presentations and program materials on our website:
Sue Birch, M.B.A., B.S.N., R.N. Director, Washington State Health Care Authority
Esther Kim, Sc.D. Program Director, Partners HealthCare
Kristen Mucitelli-Heath Administrator, St. Joseph’s Health (Syracuse, NY), Innovating Medicaid Policy
Ann Hwang, M.D. Director, Center for Consumer Engagement in Health Innovation, About CCEHI
Jeff Micklos Executive Director, Health Care Transformation Task Force, About HCTTF
What are Medicaid Program Waivers?
The presenters described many innovative initiatives such as Medicaid health homes, accountable care organizations, and managed care programs that are supported by Medicaid program waivers and demonstration projects. States may apply for formal waivers of some statutory requirements to be able to test new approaches to payment, service delivery, and program operation:
• Section 1915(b) Freedom of Choice waivers allow states to implement managed care plans for Medicaid and dually-eligible Medicare beneficiaries.
• Section 1915(c) waivers Home and Community-based Services waivers authorize states to pay for Medicaid services outside of institutions and allow beneficiaries to stay in their homes.
• Section 1115 waiver Research and Demonstration Projects give states the flexibility to experiment with pilots that promote the objectives of the Medicaid and CHIP programs while meeting budget neutrality requirements.
Thank you to the Modern Medicaid Alliance for supporting this event.
This event occurred on June 12th, 2019.