Medicaid Access & Policy
Expert articles and analysis related to medicaid access & policy.
AI Summary â Last 30 Days
The Trump CMS is positioning ACCESS as a scalable chronic-care VBC platform, expanding the model for 2027 to include heart failure, COPD, substance use disorder, and tobacco cessation while bringing in technology-enabled participants such as wearables and AI-supported care teamsâsignals that CMS wants chronic disease management to move toward digitally monitored, outcomes-oriented payment across conditions and potentially payers. At the same time, CMMI Director Abe Suttonâs push to treat the WISeR prior authorization pilot as a broader model for federal programs creates a strategic tension for providers and ACOs: CMS is pairing care-management innovation with tighter utilization oversight, even as reported WISeR implementation delays and tech failures raise operational and trust concerns. Medicaid stakeholders should watch the cross-payer implications closely, as Medicaid ACOs continue to be framed as vehicles for quality improvement in areas like maternal health while CMS tests whether Medicare models such as ACCESS expansion and WISeR prior authorization can be extended or aligned beyond traditional Medicare.
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CMS Announces Participants in Landmark Medicaid Drug Payment Model to Bring Down Drug Costs
CMS Announces Participants in Landmark Medicaid Drug Payment Model to Bring Down Drug Costs  HCI Innovation Group
New Medicaid State-Directed Payment Limits Are Likely To Decrease Medicaid Spending By 10â25 Percent In 17 States
New Medicaid State-Directed Payment Limits Are Likely To Decrease Medicaid Spending By 10â25 Percent In 17 States  Health Affairs
New Medicaid State-Directed Payment Limits Are Likely To Decrease Medicaid Spending By 10â25 Percent In 17 States
New Medicaid State-Directed Payment Limits Are Likely To Decrease Medicaid Spending By 10â25 Percent In 17 States  Health Affairs