Health Equity & SDoH
Expert articles and analysis related to health equity & sdoh.
AI Summary — Last 30 Days
CMS is pushing Medicaid policy toward tighter eligibility and financing controls just as VBC models are expected to manage higher-acuity, socially complex populations: the Trump administration’s Medicaid work requirements rule, including medical frailty exemptions, is already facing litigation from 26 states, while stakeholders are warning that exemption workflows could create coverage churn for people with HIV, behavioral health needs, and other complex conditions. At the same time, CMS’ Medicaid state-directed payment proposal implementing reconciliation-law limits is intensifying pressure on state financing arrangements that many safety-net systems and Medicaid managed care VBC strategies rely on, creating a strategic tension between federal spending restraint and population-health investment capacity. For ACOs, Medicaid MCOs, and behavioral health providers, the near-term priority is building documentation, attribution, and risk-stratification infrastructure that can preserve coverage continuity and care management eligibility as Medicaid enrollment and spending baselines reset under the 2025 reconciliation law and related CMS rules (KFF on Medicaid projections; Healthcare Dive on state lawsuit).
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