Medicaid Access Models
Expert articles and analysis related to medicaid access models.
AI Summary — Last 30 Days
CMS’s July 14 methodology update for the Long-term Enhanced ACO Design (LEAD) Model is reshaping the PY 2027 ACO business case, making the Professional Risk Option more attractive while forcing organizations to revisit regional benchmark exposure, beneficiary alignment assumptions, and TIN strategy as REACH transitions toward LEAD (Wakely analysis). At the same time, Medicaid and dual-eligible strategy is moving further into value-based contracting: Indiana’s BALANCE model would pair Medicaid GLP-1 coverage with population-health accountability, while nursing-home and dual-eligible operators face budget pressure that is pushing states and plans toward more structured VBC models ([Indiana BALANCE model](https://news.google.com/rss/articles/CBMivAFBVV95cUxPdXVqMmptLWg3dkRsME5uMzhMZGJMNmJVV3J1TzVvUHZjUlo5ZE9iTlFBNmNmMEs2NHFpU1NoT2JscWtCOEtScnJCRTY2aU82cVNiNE1OZG85al9MR1hZa0xvdVBZZlhZSFk1d1JnRjBTcDZzRU50S09ObC1WTU95c
Related Articles
Premier Weighs in on Medicaid Managed Care State Directed Payments Proposed Rule
Premier submitted comments on CMS' proposal to implement the One Big Beautiful Bill Act's provisions on Medicaid state-directed payments.
Medicaid managed care: An Explainer
A paper by Mark Shepard and Jacob Wallace (2026) has a great overview of the Medicaid managed care program. The first question one may have is, how does Medicaid managed care differ from other forms o...
Navigating State Variability in Medicaid Work Requirements
State Medicaid Bed-Hold Policies and Hospitalizations and ED Visits Among Long-Stay Nursing Home Residents
State Medicaid Bed-Hold Policies and Hospitalizations and ED Visits Among Long-Stay Nursing Home Residents JAMA
Association of Coverage-Promoting Policies With Initiation and Discontinuation of Buprenorphine Treatment During Medicaid Unwinding
Association of Coverage-Promoting Policies With Initiation and Discontinuation of Buprenorphine Treatment During Medicaid Unwinding RAND
Strengthening Access to Community Health Worker Services in New York Through Medicaid
Current Work on the Distributional Analysis of Household Income Resulting From Changes to Medicaid Policies: Working Paper 2026-09 - Congressional Budget Office (.gov)
Current Work on the Distributional Analysis of Household Income Resulting From Changes to Medicaid Policies: Working Paper 2026-09 Congressional Budget Office (.gov)
Oregon Medicaid Launches Nutrition Benefits For Members With Complex Health Conditions - open minds
Oregon Medicaid Launches Nutrition Benefits For Members With Complex Health Conditions open minds
A Profile of Dual-Eligible Individuals
Approximately 12 million people are enrolled in both Medicare and Medicaid, referred to as dual-eligible individuals. This brief examines the demographic, socioeconomic, and health characteristics of ...
Five Key Facts About Spending and Enrollment for People with Medicare and Medicaid (Dual-Eligible Individuals)
This issue brief analyzes provides a profile of enrollment and spending on dual-eligible individuals, drawing on new analysis of data on chronic conditions to show how higher rates of chronic conditio...