Michigan currently has a varied and competitive payment model landscape spanning all categories of the LAN framework. Recent partnerships with CMS have supported the state’s shift towards more unified approaches to payment reform.
- The Michigan Primary Care Transformation (MiPCT) demonstration project enhanced alignment in Category 2 payments across significant commercial payers, Medicare, and the State’s Medicaid administration during 2011—2016. The multi-payer platform developed in MiPCT will be leveraged moving forward to continue multi-payer payment reform in Michigan.
- There are a number of Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) and Next Generation ACOs in Michigan participating in Category 3 arrangements.
The State Innovation Model (SIM) partnership with CMS has ushered in the next phase of multi-payer payment reform. Both the MiPCT project and the SIM design process informed payment and care delivery reform changes to the recently procured Medicaid managed care contract, creating additional alignment across disparate payers in the State. The SIM implementation process has, in conjunction with the Medicare Access and CHIP Reauthorization Act (MACRA) incentives for advanced payment model (APM) participation, set the stage for data collection, goal setting, and performance improvement activities across payers.
In the future, Michigan will be collaboratively developing and implementing a strategy, timeline, and systematic methodology for measuring, benchmarking, monitoring, and incentivizing all payers to increase the percentage of medical expenditures paid through Categories 3B and 4.