Medicaid & Public Coverage
Expert articles and analysis related to medicaid & public coverage.
AI Summary — Last 30 Days
In the last 30 days, CMS has accelerated structural shifts in Medicaid and public coverage by rolling out new value-based care models—including the ACCESS Model, which enlists 150 digital health companies and providers but faces provider pushback due to lower-than-expected payment rates, and the ASPIRE and LEAD models, which expand the ACO approach to high-risk and pediatric populations, intensifying risk-bearing requirements for participating organizations. State Medicaid agencies, particularly in California, are also moving forward with multipayer primary care payment reform efforts to align incentives and drive enhanced population health management across payers. These developments signal heightened pressure on providers to deliver outcomes under tighter margins, and a recalibration of risk-sharing frameworks between states, CMS, and ACOs as part of a broader push for deeper cost reductions and innovation in public coverage. Key details and context can be found via CMS ACCESS Model update and AMA: ACO approach for kids at high risk.
Related Articles
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CMS releases guidance on limits to Medicaid, CHIP funding for certain noncitizens
CMS releases guidance on limits to Medicaid, CHIP funding for certain noncitizens American Hospital Association
This Northern Cheyenne Doula Was About To Start Getting Paid — Then Medicaid Cuts Hit
Montana was on track to start reimbursing doulas, who support new and expectant parents, through Medicaid this year. But state officials halted that plan amid a budget shortfall. Other such services d...
Extended Medicaid Pregnancy Coverage During COVID-19: The Impact on Enrollment and Health Care Use in the Postpartum Year
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As states scramble to supplement Medicaid cuts, MCO taxes are a tricky part of the equation
As states scramble to supplement Medicaid cuts, MCO taxes are a tricky part of the equation Becker's Hospital Review
A Closer Look at California’s Plans to Implement Work Requirements While Facing Major Budget Shortfalls Amid Cuts in Federal Medicaid Funding
This issue brief examines California's Medicaid work requirement implementation plans to provide initial insight into how California is preparing to implement work requirements amid projected state bu...
Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements Implementation Questions | KFF
From newsletter: Join HTN live in 30 min, 12p EST / 9a PST Join HTN live in 30 min, 12p EST / 9a PST We're discussing ACO LEAD and the tough choices facing state Medicaid directors and budget writers ...
Centene creates two new executive leadership roles
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In OMB’s FY 2027 Proposed Budget, Healthcare is the Big Loser
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Why Medicaid Program Integrity Is a Team Sport
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