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Date(s) - Monday, September 25, 2017, 2:00 PM - 4:00 PM

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Monday, September 25, 2017

2:00PM – 4:00PM ET

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MAC Session 9: Episode Payment Design and Implementation in Medicaid Managed Care States and MAC Wrap-Up

Session Goals

  • The first hour of this session will focus on the opportunities and challenges relevant to State Medicaid agencies and managed care organization, with discussion on questions such as:
    • What are the decision points between a Medicaid agency and the MCOs when exploring an episode model?
    •  What are the trade-offs between the state providing MCOs with broad parameters for design and implementation, versus being very prescriptive in how an APM is implemented?
    • How does the flexibility versus prescriptive decision play out in the contracting process – both between the state and the MCOs, and between the MCOs and providers?
  • The second hour will be an open mic session, in which we want to hear from all of you on the following:
    • What are the most important things you’ve learned by participating in the MAC?
    • Using the original self-assessment scale, where are you in terms of readiness to adopt?
    • What are the most pressing questions you have related to how to get to the next step in APM adoption?
    • What is on your “wish list” in order to keep making progress.

Session Materials

Expert Discussants

  • Douglas Fish, Medical Director, New York State Department of Health

To achieve the goal of better care, smarter spending, and healthier people, the U.S. health care system must substantially reform its payment structure to incentivize quality, health outcomes, and value over volume. The Health Care Payment Learning and Action Network (LAN) was established as a collaborative network of public and private stakeholders, including health plans, providers, patients, employers, consumers, states, federal agencies, and other partners within the health care community.


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