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Value-Based Purchasing

The Value-Based Purchasing MAC Collaborative will help state Medicaid agencies to buy better value by linking quality, payment reform, and integrated care models. As the largest insurer in the country in terms of covered lives, Medicaid can better leverage its value-based purchasing power to achieve higher quality at lower cost.

This collaborative will consist of two Phases:

  1. Phase One of this MAC Collaborative will focus on ways to improve care and lower costs in non-risk based arrangements (e.g., primary care case management, fee-for-service) and to develop: (a) payment policies; (b) integrated care models; (c) quality measurement policies; and (d) beneficiary protections.
  2. Phase Two of the collaborative will target states that predominantly contract with managed care organizations (MCO). The goal of the collaborative will be to help states be more aggressive purchasers of care (acute, behavioral, and long-term care supports and services) and design the next generation of MCO contracting requirements that drive innovation in integrated care and care management programs, quality measurement, financing options, and payment reform.  

Phase One of the Value-Based Purchasing MAC Collaborative began in February 2012 and will run through August 2012 or later.

Participating States

  • Arkansas
  • Colorado
  • Connecticut
  • Illinois
  • Maine
  • Minnesota
  • Missouri
  • Oklahoma

Facilitators and Subject Matter Experts

Lead Facilitators

  • Dianne Hasselman, Director of Quality and Equality, Center for Health Care Strategies
  • Tricia McGinnis, Senior Program Officer, Center for Health Care Strategies

Lead Subject Matter Experts

  • Carol Backstrom, Senior Policy Advisor, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services
  • Barb Edwards, Director, Disabled & Elderly Health Programs Group, Center for Medicaid and CHIP Services, Centers for Medicare & Medicaid Services