By Athena Mandros

Medicaid health plans are moving ahead with the shift to alternate payment methodologies (APM) at a relatively rapid rate. Twenty-two states require health plans to move to value-based reimbursement and eleven states use Medicaid accountable care organizations (see Success Today, Success Tomorrow – Strategy Issues in The Changing California Behavioral Health Market). The question our team is asking – is Medicaid financing—for physical health, behavioral health, and pharmacy—properly aligned for value-based reimbursement (VBR)? If integrated care coordination and VBR are going to have a meaningful impact on "bending the cost curve", financial alignment is important. The more fragmented the financing,…
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