MediCal Explained: What Are Alternative Payment Models?

Authors: Athena Chapman, Samantha Pellón
Year: 2022
State: CA
Website link:
Publicly Available: Yes
Policy: General other, Legislative language, Lessons learned from other states
Sustainable Financing: CMS and CDC engagement from a national level, How to engage and work with Medicaid, Including community-based CHWs, Education to HC orgs on payment options bundled etc., Reimbursement TA for FQHCs Medicaid etc.

Over the past decade, the Centers for Medicare & Medicaid Services (CMS) has increasingly used health care provider payment reforms that encourage better value in the health care system. These payment reforms are known as alternative payment models (APMs) and are defined as a provider payment method that uses financial incentives for the provision of care that is high-quality, cost-efficient, or both. This issue brief explores how Medi-Cal, California’s Medicaid program, has been developing APMs to align with these federal initiatives and state financial and policy goals.

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