Medicaid Managed Care
Expert articles and analysis related to medicaid managed care.
AI Summary â Last 30 Days
CMS is pushing Medicaid managed care further into multi-payer, value-based infrastructure: the ACCESS Model is drawing major payer and digital-health participation, but its lower-than-expected payment rates are creating tension over whether safety-net and Medicaid-focused providers can sustainably deliver enhanced access and population-health services under the model (CMS ACCESS payer pledge). At the state level, Medicaid agencies and safety-net stakeholders are positioning around primary care and HCBS quality as the next VBC battleground, with Californiaâs Medi-Cal multipayer primary care concept and CMSâ proposed 2028 HCBS quality measures signaling a shift toward standardized accountability, cross-payer alignment, and stronger expectations for managed care plans to finance longitudinal care models (Medi-Cal primary care payment reform). Meanwhile, CMSâ extension of the GENEROUS Model deadline suggests the Trump administration is keeping Medicaid drug-cost innovation in play, creating potential openings for state Medicaid programs and MCOs to link pharmacy affordability, benefit design, and outcomes-based contracting.
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