Medicaid funds typically cannot be used to pay for non-medical interventions that target the social determinants of health. However, in October 2018, CMS approved North Carolina’s Section 1115 waiver which provides financing for a new pilot program, called “Healthy Opportunities Pilots,” to cover evidence-based non-medical services that address specific social needs linked to health/health outcomes. The pilots will address housing instability, transportation insecurity, food insecurity, and interpersonal violence and toxic stress for a limited number of high-need Medicaid enrollees. This brief summarizes key features of the pilots.
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Research demonstrates that improving population health and achieving health equity will require broad approaches that address social, economic, and environmental factors that influence health. This brief provides an overview of the broad factors that influence health and describes efforts to address them, including initiatives within Medicaid.
The Center for Medicare and Medicaid Innovation (CMMI), also known as the “Innovation Center,” was authorized under the Affordable Care Act with the goals of designing, implementing, and testing new payment and delivery system reform models to address concerns about rising costs, quality of care, and inefficient spending. These FAQs provide an overview of the Innovation Center, as well as details on model performance, beneficiary involvement, and more.
New Interactive “Evidence Link” Examines the Latest Results on Savings and Quality in Medicare Payment Models
A new interactive resource from the Kaiser Family Foundation synthesizes the most up-to-date evidence on Medicare’s efforts to reduce the growth in health care spending and improve patient care through new payment and delivery reform models. KFF’s Evidence Link is a central source of information and data about Medicare accountable care…
ACOs are groups of doctors, hospitals, and other health care providers who voluntarily form partnerships to collaborate and share accountability for the quality and cost of care delivered to their patients. These FAQs describe the ACO models in Medicare and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare accountable care organization (ACO) FAQs are part of the Medicare Delivery System Reform Evidence Link.
Medical homes are typically team-based primary care practices that provide the majority of their patients’ health care needs either directly, or through coordination with other providers. These FAQs describe the medical home models in Medicare, and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare medical home FAQs are part of the Medicare Delivery System Reform Evidence Link.
Bundled payment models are a way for Medicare to establish a total budget for all services provided to a beneficiary throughout an episode of care. These FAQs describe the different types of Medicare bundled payment models, and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare bundled payment FAQs are part of the Medicare Delivery System Reform Evidence Link.
The Kaiser Family Foundation’s Evidence Link is an interactive resource that pulls together the latest available evidence on Medicare payment and delivery system reform models, with an initial focus on accountable care organization (ACO), medical home, and bundled payment models. Through FAQs and side-by-side comparison tables, the Evidence Link synthesizes the most up-to-date information on savings and quality results, and describes key design features of each Medicare model, such as how providers are paid, the number of beneficiaries receiving care under each model, where models are being tested, and timelines for evaluations.
Use this contact form to provide comments, suggestions, and/or questions about the Medicare Delivery System Reform Evidence Link, or to sign up for Medicare email alerts.
This tutorial walks users through the Medicare Delivery System Reform Evidence Link, including its FAQs and side-by-side comparison tables on Medicare accountable care organization (ACO), medical home, and bundled payment models.