Advancing Delivery and Payment Reform in Managed Care Provider Networks: Tools for State Purchasers
States purchase health care benefits for more than a third of all Americans — nearly one quarter of all Americans receive coverage through Medicaid and about 14 percent of working Americans are state or local government employees. Because managed care plans oversee health care services for most Medicaid beneficiaries, public employees, and those getting coverage through the marketplaces, health plans are key channels through which state purchasers can accelerate the shift away from fee-for-service reimbursement toward value-based purchasing (VBP). CHCS developed this toolkit, which is comprised of a brief on Strategic Considerations for State Purchasers, an Implementation Guide for State Purchasers, and Planning Template for Value-Based Purchasing – to help state purchasers design and implement effective VBP strategies within managed care.