CMS Guidelines Promote Value-Based Medicaid Payments
Monday, October 26th, 2020

Recently, CMS provided guidelines to assist states with increasing the acceptance of a value based system through their Medicaid programs. The organization has pledged to promote value-based care within Medicare and is encouraging states to make similar attempts to make the same promotion through their Medicaid services. Medicare, Medicaid, and commercial providers overlap greatly. The guidance emphasizes the value of multi-payer alignment in assuring value-based care moves toward the conversion of the healthcare delivery system.

The guidelines include a host of additional concerns Medicaid directors may need to address, including how ready the delivery system is, stakeholder involvement, and financial uncertainty for providers. It also explains how states may utilize their current leverage in their Medicaid systems to implement value-based payments, including with managed care and Medicaid fee-for-service.

Numerous politicians and healthcare authorities have long supported widespread acceptance of value-based payments, which connect financial incentives from providers to the quality of treatment they offer to their patients. Per the Health Care Payment Learning and Action Network, roughly a third of healthcare payments were value-based in 2018.

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This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.