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Alternative Payment Models in Medicaid - Deloitte Research: Could MACRA be Catalyst for State Efforts?
Alternative Payment Models in Medicaid - Deloitte Research: Could MACRA be Catalyst for State Efforts?
Medicaid can be overlooked in conversations about value-based strategy, but state initiatives can present major opportunities or challenges for health plans and health care providers. ​Many states have been experimenting with Medicaid alternative payment models (APMs) to try to control spending, improve care, and increase accountability within Medicaid and across the health care system. But have any of these models worked? And how might Medicaid initiatives align with the Medicare Quality Payment Program (QPP) established by the Medicare Access and CHIP Reauthorization Act (MACRA) to reinforce value-based care initiatives and drive system-wide change?

The Deloitte Center for Health Solutions has reviewed research and other literature and conducted interviews with industry experts and stakeholders to learn more about Medicaid APMs, their effectiveness, and how they might need to evolve to maximize their impact. Deloitte found that although many state initiatives are underway, relatively few have been evaluated for their impact on total cost of care of health outcomes. The potential impact of Medicaid alternative payment models on care delivery can depend considerably on how much of a provider's revenue comes from Medicaid. Medicaid models may need to evolve to incorporate more financial risk and increase participants' meaningful use of electronic health records (EHRs) to qualify as advanced APMs under MACRA.

Despite limited evidence, APMs continue to spread, and federal and state policies are increasing pressure on providers and insurers to participate. Aligning Medicaid APMs' design, reporting requirements, and financial incentives with other payers could potentially increase their impact and likelihood of success. This could be particularly true for specialists or other providers who treat a low volume of Medicaid patients.

Please join us Wednesday, October 25th, 2017 as Deloitte's Erica Cischke and Claire Boozer Cruse share Deloitte's insights and research findings.
Click here for detailed information and to register or call 209.577.4888.
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