State Strategies: Value-Based Payment for Medicaid Populations with Complex Care Needs

Authors
Erin Taylor
Mary Beth Dyer
Michael Bailit
Brief/Report
April 2017

This resource examines Medicaid payment reform strategies for populations who receive LTSS. It includes case studies of state programs in Tennessee, Minnesota, and Arizona. 

  • A growing number of states are implementing value-based payment programs to deliver LTSS to Medicaid populations with complex needs.
  • Payment models include pay-for-performance, supplemental per-member per month payments, shared savings/shared risk, and episode-based payments.
  • Measurement strategies for value-based LTSS payment may need to consider less traditional domains such as quality of life, independence, and functional status.
  • States can support and direct value-based strategies in various ways, including grants or capacity-building opportunities for LTSS providers.
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Key Questions Answered
  • What are some promising strategies for states to improve payment models for long term services and support (LTSS)?
  • What are some examples of states that have implemented these reforms successfully?
Level of Evidence
Promising
What does this mean?