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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• Long-term Enhanced ACO Design (LEAD) Model

Missouri Rebids Medicaid Managed Care Contracts Including Plan For Special Needs Children

The Missouri Department of Social Services (DSS), MO HealthNet Division, is rebidding its statewide Medicaid managed care organization (MCO) contracts. Request for Proposals (RFP STATE 0000000463SL) was released on July 1, 2026, with proposals due by September 2, 2026. Readiness reviews are scheduled to run from January 1 through March 30, 2027. The contracts will run for one year, with four optional one-year renewal terms. The RFP seeks bids for a general plan and a… Read

• What Is The ‘Value’ Of Health Care?
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• Who Moved The Medicaid Cheese? A Look At Some Of The Largest 2025 Contract Awards
• Understanding Medicaid Managed Care Procurement Practices Across States
• Medicaid Managed Care Procurements: A Toolkit For State Medicaid Agencies

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