Delivery System Redesign

The Affordable Care Act provides new opportunities to integrate care for individuals dually eligible for both Medicare and Medicaid, but states now face challenges in showing how these integrated models improve the quality care. This brief summarizes efforts to develop quality of care measures for Medicare-Medicaid enrollees. It provides guidance to states in developing measurement approaches for proposed integrated programs, including assessment of quality in specific domains of integrated care such as long-term services and supports and behavioral health services. It also describes how performance measures can be shaped by stakeholder input.

Half of state Medicaid programs are taking new approaches to provider payment to help primary care practices become patient-centered medical homes for their low-income patients. This article focuses on trends in Medicaid patient-centered medical home payment that can inform public and private payment strategies more broadly.

Leading-edge states across the country are exploring the potential of accountable care organizations (ACOs) to drive improvements in quality, delivery, and cost-effectiveness for Medicaid populations. This brief outlines 10 core considerations to help guide the development and implementation of Medicaid ACO approaches.

The Center for Improving Value in Health Care has officially launched the Colorado APCD. The database, created under legislative authority in 2010, includes claims data from commercial health plans, Medicare, and Medicaid.

In this brief, Manatt Health Solutions examines joint rules proposed by the U.S. Departments of the Treasury, Labor, and Health and Human Services for wellness program incentive.