ADEA State Update

National Governors Association to Focus on Medicaid Transformation

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The National Governors Association (NGA) announced that Alabama, Nevada and Washington will participate in a year-long project to examine ways to spur changes in how states pay for Medicaid and other health care services.

Participating states will work with experts within the NGA Center for Best Practices, other national experts and peers to identify ways to accelerate the pace of statewide Medicaid reforms. They will examine financing issues, stakeholder relations, data analytics, quality reporting, performance metrics and evaluation, the role of managed care and workforce development.

The project will culminate in individual “agreements in concept” tailored to the specific needs of each participating state and designed to help states reach successful agreements with the U.S. Department of Health and Human Services. The agreements in concept could take the form of waivers, state plan amendments, performance partnerships or other mutually agreed-upon arrangements between a state and the federal government and include the following core elements: 

  • The potential for systemic payment and delivery reform across a state focused on improving health outcomes, improving the delivery of care and lowering health care costs;
  • Shared risk between states and the federal government including, for example, the ability for states to benefit from the savings generated in Medicaid, Medicare or other federal programs; and
  • A comprehensive quality and accountability strategy. 

“Governors are uniquely situated to look across their entire health systems to create solutions that span both the public and private markets,” said Gov. Robert Bentley (R-AL). “Through collaborative efforts among state agencies, communities, stakeholders, payers and providers, governors can steer action towards a common vision of a transformed health care system for a state.”

According to the National Conference of State Legislatures, Medicaid is overwhelming state budgets. In 2012, the states’ share of the joint state-federal program accounted for an average of 15% of state general funds. Additionally, 10 states—California, Colorado, Louisiana, Maine, Maryland, North Carolina, Pennsylvania, Tennessee, Washington and West Virginia—made mid-year revisions to close 2012 Medicaid budget gaps.

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