Medicaid & Safety Net

Medicaid agencies and safety-net plans are moving deeper into care-delivery redesign: CalOptima is expanding its street medicine program in Orange County, while Kentucky has launched Medicaid reentry coverage for people preparing to leave state custody—both reinforcing VBC priorities around high-need populations, avoidable ED/inpatient use, and continuity of care after institutionalization. At the same time, MACPAC is pressing Congress and states on operational levers that directly affect Medicaid managed care and provider risk arrangements, including automation in Medicaid prior authorization, PACE oversight, pediatric behavioral health residential access, and PBM practices—signaling continued tension between administrative efficiency, access protections, and cost control in Medicaid VBC contracts. New York’s push to expand behavioral health data access in EHRs further underscores the operational importance of interoperability and data-sharing for whole-person care models.