Home-Based Care Payment Models Focus on Value, Risk, and Coordination
Industry leaders at the PAYER Summit identified three payment trends reshaping home-based care delivery: value-based payment arrangements replacing fee-for-service, increased provider risk-sharing with managed care organizations, and stronger payment incentives for care coordination across post-acute settings. These shifts affect how MCOs structure home health and home-based primary care contracts. The trends reflect broader movement toward outcomes-based reimbursement in Medicaid managed long-term services and supports. Payer executives and providers agreed these payment changes will determine which home-based care organizations remain viable partners for health plans.
Medicaid MCOs contracting for home health and LTSS must adapt payment models to align with value-based care expectations and prepare providers for increased financial risk.
LTSS · Long-Term Care · Managed Care
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