Modifying the Focus of Medicaid Value-Based Payment in the Context of COVID-19

Medicaid programs play a key role in supporting the health care system’s transition to the new normal created by the COVID-19 crisis. States and managed care organizations (MCOs) are considering how to stabilize the finances of provider organizations and support new care delivery capabilities, including telehealth. This work includes assessing the impacts of the COVID-19 pandemic on value-based payment (VBP) programs and adapting these models to a new health care context.

Given these challenges, states and health plans will need to consider how to adapt VBP models to the pandemic context, which is a key step in considering how to adjust VBP program goals and expectations. While reduced cost and increased quality have historically been the leading measures of success, the realities of COVID-19 may require a new or adapted VBP focus in the near-term.