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Capitol Correspondence - 05.28.19

Commonwealth Fund Reports on How States Assess Primary Care Quality in Medicaid Managed Care

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ANCOR is summarizing this blog post by the Commonwealth Fund because states are increasingly considering expanding managed care to Medicaid-funded supports for people with intellectual / developmental disabilities (I/DD). I/DD supports have traditionally being excluded from managed care because of the unique needs of people with disabilities, but this is fast changing. As such, this post could help providers of I/DD supports keep track of implementation trends as they navigate the managed care terrain. Readers interested in learning more about managed care and I/DD might consider ANCOR’s white paper on the topic as well as the HCBS Business Acumen Center, of which ANCOR is a sub-grantee.


The Commonwealth Fund blog post states: “Where Medicaid is concerned, the road to primary care delivery and payment reform runs through managed care. States’ quality strategies show the breadth and ambition of the quality goals they have set. How states might use payment reform as a tool for achieving these goals is a strategic question that carries implications for the relationship that states choose to maintain with participating MCOs.”

The blog post highlights the following trends in strategies (please read the full text linked above for state-specific examples):

  • Three-quarters of the state strategies explicitly plan to use managed care as a means of identifying and addressing underlying social determinants of health, such as housing or transportation needs.
  • Most states identify greater patient/family/caregiver engagement as a priority. Developing plans that offer care and support patients and families in a culturally competent fashion is a goal of nearly every state.
  • Compared to health care access or care integration, for example, fewer state quality strategies discuss their payment reform plans; about half do so.