Medicaid Managed Care
Expert articles and analysis related to medicaid managed care.
AI Summary — Last 7 Days
CMS is pushing Medicaid managed care toward more standardized quality accountability, opening comment on a proposed 2028 HCBS Quality Measure Set that would affect Medicaid LTSS plans, home care providers, assisted living operators, and states seeking to demonstrate access, experience, and outcomes performance in HCBS programs (HCBS measure analysis). At the same time, CMS extended the application deadline for the GENEROUS Medicaid drug pricing model after strong manufacturer interest, signaling continued federal appetite for Medicaid-focused payment innovation even as states and plans weigh operational complexity, pharmacy savings, and VBC alignment (GENEROUS deadline extension). The week’s throughline is tighter measurement and cost-control experimentation in Medicaid managed care—especially HCBS, pediatrics, and pharmacy—creating opportunities for value-based partnerships but also raising provider concerns about administrative burden, data readiness, and whether quality metrics will translate into sustainable rates.
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