Some of the biggest shifts and improvements in government healthcare programs may be happening at the state level, according to a survey. In 2015, nearly 60% of Medicaid directors across the country spent half or more of their time working on major payment, delivery system or programmatic reforms, according to a survey by the National Association of Medicaid Directors. The survey also showed:
- Payment and delivery system reform is at the top of Medicaid agency innovations;
- Agencies are moving to performance-based reimbursement models within both traditional fee-for-service care delivery and managed care;
- High priorities for states include patient-centered medical homes, health homes, alignment of physical and behavioral health, super-utilizer programs and population health; and
- Top issues for four-fifths of the agencies include managed long-term services and support and managed behavioral health programs.
Most directors cite factors such as limited staffing, data and systems infrastructures, administrative budgets and complex procurement processes as barriers to innovation.