Wednesday’s Medicaid Reform meeting hosted by CSG-ERC Health Policy Committee
highlighted the variety of approaches states are taking to address their unique
challenges. All states are committed to move away from volume-based payment
models toward building value. All states were also committed, and have devoted
significant resources, to quality improvement and delivery reform to build
programs that are centered on patients. But states face different challenges,
cultures and capacity. The all-day meeting at the Boston State House included
Medicaid officials, legislators, staff, federal officials and other
stakeholders. We heard from Bailit
Health researchers about their recent survey of Medicaid reforms across the
US. The survey found that states are moving into value-based purchasing because
of strong pressure from CMS, internal strategic priorities, budget constraints,
and active policymakers. State Medicaid programs are moving more slowly and
tentatively into financial risk models than the private sector because of the
unique nature of the program, its providers and members. We also heard from NESCSO, a non-profit organization funded by New
England states to support state Health and Human Service Agencies. NESCSO
provides staff training, information exchange, and collaborative solutions such
as joint purchasing of services to support reform. NESCSO is planning to bring panels
of federal health officials to states. To start the lively Policymakers’
Roundtable discussion we heard from Medicaid officials from NY, MA, RI, VT and
CT. Discussion focused on what has worked and where the challenges still are. One
member noted that “Medicaid reform is not like flipping a switch. It’s more
like slowly turning up a dimmer.” We heard about new DSRIP opportunities,
Accountable Care Organization development and regulation, underservice
protections, multipayer collaboration, aligning quality targets, addressing
social determinants of health, re-focusing programs on members’ needs, strengthening
primary care and care coordination. The main request from participants to
CSG-ERC for the future was to continue opportunities to meet and share
resources. Slides and other documents will be posted online soon.
