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Medicaid rolls grew by nearly 14% last year as 9.9 million consumers enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) between February 2020 and January 2021. With more than 80 million consumers—including 38.3 million children—on the rolls, Medicaid and CHIP combined now serve as the largest single source of health coverage in the United States (see New Medicaid & CHIP Enrollment Snapshot Shows Almost 10 Million Americans Enrolled In Coverage During The COVID-19 Public Health Emergency).

But in the face of swelling rolls and increasing socioeconomic challenges for vulnerable consumers, Medicaid plans . . .

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Managed Care & Value-Based Reimbursement

The impending shift to value-based reimbursement (VBR) and managed care in the health and human services industry has become a driving force across both public and private sector organizations, not only forcing new operating models and systems, but pushing providers to develop new partnerships with payers and to prepare for population health management. This shift presents organizational, technical, and cultural challenges that require a robust technology infrastructure, data-driven decisionmaking, and new leadership competencies. As behavioral health provider organizations move towards risk-based contracts, those who adapt to this change will have a better opportunity to carry forward in the provision of value-based services.

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Arizona Medicaid Contract For Elderly/Disabled Members Changed After Protest
On May 2, 2025, the Arizona Health Care Cost Containment System (AHCCCS) announced it had entered a settlement agreement and awarded four contracts for the Arizona Long Term Care System-Elderly and/or Physically Disabled (ALTCS-EPD) program. The settlement agreement resolves a procurement protest. The awardees are Arizona Physicians IPA, Inc. (dba UnitedHealthcare Community Plan); Banner-University Care Advantage (dba Banner-University Family Care); Mercy Care, and Bridgeway Health Solutions of Arizona, Inc. (dba Arizona Complete Health-Long Term Care).… Read

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