93% Of Medicaid Health Plans Reported Using Value-Based Payment Or Alternative Payment Models

Approximately 93% of Medicaid managed care organization (MCO) plans reported using value-based payment (VBP) or alternative payment models (APMs) during 2019. About 79% of the plans reported that their state contracts required them to implement VBP contracting with provider organizations. All Medicaid MCOs with more than 250,000 lives reported using VBP or APMs; about 80% of MCOs with up to 250,000 covered lives also used VBP and APMs.

The percentage of payment through APMs to primary care provider organizations and hospitals varied with health plan size. About 43% of Medicaid MCOs made between 1% and 15% of . . .