Health Plans Face Key Decisions in Rolling Out Outcomes-Based Payment Models for Tech-Enabled Chronic Care

This piece analyzes the implementation challenges facing health plans that signed CMS's Payer Pledge to adopt outcomes-based payment for technology-enabled chronic disease management by 2028. While CMS's ACCESS model provides a framework for Original Medicare, participating plans—including Medicaid MCOs—must independently determine which conditions to target, how to structure payment, what outcomes to measure, and how to operationalize vendor relationships. The authors outline strategic considerations for plans to translate the pledge into functional payment models that can genuinely improve quality and cost outcomes.

Managed Care · Behavioral Health · Finance

This is outside commentary from Manatt Health, not part of Medicaid Monitor's independently scored news coverage.

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