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Since its inception 51 years ago, Medicaid has evolved from a small welfare program into an integral part of the nation's health insurance system. Today, Medicaid is the country's largest insurer and the single largest payer in every state, covering more than 20% of the U.S. population.

Although it is unquestionably an essential part of the nation’s insurance foundation, Medicaid is facing profound challenges in 2018—from potentially dramatic changes in its financial structure to a possible rollback of the expansion option introduced under the Affordable Care Act (ACA).

In this webinar, Manatt Health reveals the top 10 Medicaid trends—and their implications—that you need to watch in 2018 and beyond.

Date and Time

The webinar was held on February 13, 2018

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States are becoming increasingly demanding in their expectations of Managed Care Organizations (MCOs) when it comes to care management. Formerly a domain solely left to MCOs, many states are pushing health plans to move beyond a cubicle-and-telephonic approach, requiring new care management models that have the potential to change the way care is delivered. What does this mean for MCOs, providers and patients? How have these new requirements been reflected in state contracts with MCOs? What opportunities and challenges does this create for both small practices and provider-led organizations, such as Accountable Care Organizations and Clinically Integrated Networks?

Date and Time

The webinar was held on May 24, 2018

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States are increasingly enrolling children with complex physical and behavioral healthcare needs, including children in foster care and those receiving waiver services, in Medicaid managed care. Many of these states are expecting more of their contracted managed care plans to ensure vulnerable children’s needs are addressed through the managed care delivery system. Which states have robust requirements in place—and what themes are emerging?

Date and Time

The webinar was held on June 20, 2018

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There is a growing trend among states to develop more rigorous methods for overseeing and enforcing contract requirements with Medicaid managed care organizations (MCOs). Many states have increased their use of liquidated damages, as well as created financial incentives for plans to make fraud referrals or participate in fraud and abuse investigations and recovery processes. States often report, however, legislative and regulatory obstacles to exercising their authority. This trend has impacted the way MCOs must conduct oversight and has downstream effects on providers.

In this webinar, we explore the differences and similarities among states in enforcing Medicaid MCO contract requirements. We also examine expectations regarding MCOs’ participation in program integrity activities and the impact on MCOs and providers.

Date and Time

The webinar was held on June 27, 2018

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States have long relied on supplemental payments to provide additional funding to hospitals and other providers. Though reliance on these payments varies, in some states they account for a fifth of total Medicaid expenditures. Recently, however, the Centers for Medicare & Medicaid Services (CMS) curtailed states’ ability to make supplemental payments to providers in managed care. As a result, many states and providers are seeking strategies to preserve essential provider funding streams in managed care systems.

In this webinar, we explore the options states have for addressing the challenges of supplemental payments in managed care.

Date and Time

The webinar was held on July 19, 2018

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Over the past year, federal and state policy makers have advanced proposals that would permit people above Medicaid eligibility levels to “buy in” to Medicaid or would leverage the Medicaid program to offer more affordable and accessible coverage. As stability concerns persist in most markets, Medicaid buy-in proposals are beginning to gain traction as potential solutions to access, affordability and continuity of health coverage.

What central considerations must be taken into account when developing Medicaid buy-in proposals? What are the evolving models for state-administered Medicaid buy-in proposals? And what are the administrative considerations and authorities needed for each model?

Date and Time

The webinar was held on October 11, 2018

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State Medicaid programs continue to balance serving eligible beneficiaries and controlling costs. In an environment sharply focused on the cost of drugs, it is increasingly critical to understand the Medicaid pharmacy benefit and the role health plans play in managing that benefit.

Date and Time

The webinar was held on October 17, 2018

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With mounting evidence demonstrating the influence of nonclinical and social factors—such as unstable housing, food insecurity and interpersonal violence—on health outcomes and healthcare costs, social determinants of health (SDOH) have edged into the mainstream. State Medicaid agencies and other stakeholders are driving the SDOH evolution from theory to practice. Recognizing that solving the healthcare problem starts with attacking its root causes, they are increasingly developing innovative strategies to address Medicaid enrollees’ SDOH-related needs and crafting sustainable funding solutions.

In this webinar, Manatt Health reviews the role that Medicaid agencies and managed care plans are playing in testing SDOH-related interventions and integrating them into their healthcare delivery systems—creating a platform for “whole person” care that seamlessly addresses individual physical, behavioral and social needs.

Date and Time

The webinar was held on October 30, 2018

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As healthcare costs continue to rise and stakeholders maintain focus on improving care quality and outcomes, payers are turning to value-based payment (VBP) as a critical tool for boosting delivery system performance. As the nation’s largest health insurer, Medicaid is no exception to the growing trend of rewarding value. Across the country, state Medicaid agencies are seeking to increase provider accountability for both the quality and cost of care—and many of the 39 states with comprehensive, risk-based Medicaid managed care are using those programs to help achieve their goals.

Exactly how are states leveraging Medicaid managed care to advance VBP? Manatt answers that critical question in an all-new webinar—the final in our Medicaid managed care series.

Date and Time

The webinar was held on November 27, 2018

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