Incorporating Value-Based Payment into State-Directed Payment Arrangements can Improve Outcomes for Dually Eligible Individuals

Incorporating Value-Based Payment into State-Directed Payment Arrangements can Improve Outcomes for Dually Eligible Individuals

Published: Oct 25, 2023
Publisher: Health Affairs Forefront

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Associated Project

Supporting CMS and State Use of Medicaid Managed Care Payment Strategies

Time frame: 2021-2026

Prepared for:

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services

Authors

Michaella Morzuch

The high rates of health care needs among dually eligible individuals concern many policymakers. For the eleven million dually eligible individuals enrolled in Medicaid managed care plans, state-directed payments are a powerful yet underused payment tool to reward plans and providers for producing better outcomes. In this Health Affairs Forefront article, we explain what SDPs involve and how states can use them to create incentives for health plans to improve health outcomes for dually eligible individuals.

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