Managed Medicaid

Insurers Applaud New CMMI Push for Risk-Based Contracting

The Biden administration has revamped the strategy of the Center for Medicare and Medicaid Innovation: In the coming years, CMMI will focus on consolidating models, increasing insurer and provider participation in models, and advancing equity — and it aims to have most Medicare and Medicaid members served by value-based payment models by the end of the decade. Health care insiders applauded the new direction, saying the “strategy refresh” should bring the agency closer to its original mission and make its budget go further.

CMMI has tested more than 50 models since its creation in 2010 as part of the Affordable Care Act. Experts outside the agency have criticized the proliferation of models: The Medicare Payment Advisory Commission (MedPAC) recommended in June that HHS “should implement a more harmonized portfolio of fewer alternative payment models that are designed to work together to support the strategic objectives of reducing spending and improving quality.”

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MVP Health Care Taps Into ‘Underserved’ Market With D-SNP

Schenectady, N.Y.-based MVP Health Care has long served Medicare beneficiaries in New York and Vermont with Medicare Advantage and Medicare Savings Account plans. It is also a contractor for the New York State Medicaid program, caters to employers, and offers individual and family plans on and off the Affordable Care Act exchanges. For 2022, the not-for-profit insurer is launching a Dual Eligible Special Needs Plan (D-SNP) through a joint venture with Belong Health, a new company that was co-founded by former Cigna Corp. executive J. Patrick Foley and specializes in helping regional payers launch MA and SNP products.