Adapting a Senior Focused Care Strategy to Medicaid
New Risk, New Business Models
Provisions in the Affordable Care Act have expanded health care access to millions of previously uninsured Americans. In many states, the largest coverage gains have come from expansions of state Medicaid programs. Notwithstanding the benefits of expanded coverage on access and self-reported health, the Medicaid program — now the largest insurer in the country — remains rich with opportunities to ensure that all Medicaid beneficiaries receive high-value, coordinated care.
To embark on this path, many have launched new payment arrangements or expanded the use of existing alternative payment structures (such as managed care organizations) to promote the development of delivery models that improve the value of care delivered to Medicaid populations. The growth of these arrangements represents a substantial opportunity to redesign care for the vulnerable populations that need it most.