States Tighten Value-Based Payment Mandates in Medicaid MCO Contracts

State Medicaid agencies are shifting from voluntary encouragement to mandatory requirements for MCO value-based purchasing arrangements, with many now setting specific targets, timelines, and accountability measures tied to the LAN framework. The analysis finds states are using VBP mandates as the primary tool to drive maternal health, behavioral health, and health equity outcomes, requiring MCOs to demonstrate provider readiness, data infrastructure, and financial risk management capabilities. This evolution makes VBP competency a competitive differentiator in procurement and places new performance pressure on both plans and their provider networks.

Managed Care · Finance · Behavioral Health · Maternal

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

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