Source

Center for Health Care Strategies

11 stories

Seven States Improve Medicaid Access to Continuous Glucose Monitors Beyond Coverage Mandates

Seven states implemented strategies to strengthen access to continuous glucose monitors (CGMs) for Medicaid enrollees with diabetes, going beyond coverage policies to address utilization barriers. The Center for Health Care Strategies report examines how these states improved actual device uptake and diabetes care outcomes. The findings highlight operational approaches to bridge the gap between coverage on paper and real-world access. This matters for state Medicaid agencies and managed care plans working to translate diabetes technology coverage into measurable improvements in member health outcomes.

chcs.org

State Policy·21d ago

Pennsylvania, Nevada, Wisconsin Medicaid Directors Detail Member Engagement Strategies

Three state Medicaid directors describe operational approaches for gathering and acting on member feedback, including advisory councils, community listening sessions, and embedding member voices in agency decision-making. The leaders discuss how they structure engagement to reach diverse populations, particularly members with complex needs, and translate input into policy and operational changes. These practices aim to improve program responsiveness and member experience across eligibility, benefits, and service delivery.

chcs.org

Managed Care·29d ago

CHCS Report Examines Social Media Effects on Children's Behavioral Health

The Center for Health Care Strategies published a discussion with Stephanie Marcello, PhD exploring how social media and technology affect children's behavioral health. The report addresses concerns relevant to Medicaid managed care organizations that cover behavioral health services for children and adolescents. It builds on ongoing policy discussions about youth mental health and digital technology exposure. The analysis may inform MCO strategies for addressing behavioral health needs in pediatric populations.

chcs.org

State Policy·NY·34d ago

Report Outlines Strategies to Expand New York Medicaid CHW Benefit

A new report from the Center for Health Care Strategies provides recommendations for expanding community health worker services under New York's Medicaid program. The analysis addresses opportunities for state policymakers, managed care organizations, and CHW stakeholders to strengthen implementation of the state's CHW benefit. Recommendations focus on enhancing access, improving reimbursement structures, and scaling CHW integration within Medicaid managed care networks. The report is published in July 2026.

chcs.org

State Policy·50d ago

CHCS Reviews 15 Years of Medicaid Leadership Development Programs

The Center for Health Care Strategies published a retrospective analyzing over 15 years of Medicaid leadership development initiatives funded by the Robert Wood Johnson Foundation. The review examines programs designed to strengthen state Medicaid agency capacity through executive training, peer learning networks, and leadership support. The analysis documents approaches used to build technical and strategic capabilities among state Medicaid directors and senior staff. For managed care organizations, state agency leadership stability and expertise directly affect contract oversight quality, rate-setting processes, and the consistency of MCO performance requirements.

chcs.org

State Policy·51d ago

CHCS Report Outlines State Strategies to Address Social Isolation Among Older Adults

The Center for Health Care Strategies published a report examining how states and communities can help older adults build social connections and reduce isolation. The report identifies strategies for state Medicaid agencies and community organizations to support older adults in connecting to social resources. It addresses a population health priority relevant to states implementing Medicaid LTSS programs and managed care plans serving dual-eligible beneficiaries. The guidance is particularly relevant for states operating HCBS waivers and integrated care models where social determinants of health are increasingly incorporated into care management.

chcs.org

Industry·51d ago

CHCS Report Examines Women's Financial Security Challenges Including Health Care Costs

The Center for Health Care Strategies published a report examining how caregiving responsibilities, health care costs, longer lifespans, and workforce participation patterns affect women's financial stability as they age. The analysis explores structural factors that create financial vulnerability among women over their lifetimes. While the report addresses health care costs as one component of women's financial challenges, it does not announce or analyze specific Medicaid policy changes, program rules, or managed care operations.

chcs.org

Managed Care·51d ago

Transportation Access Shapes Health Outcomes for Older Adults in Medicaid Programs

Transportation barriers significantly affect health care access and outcomes for older adults enrolled in Medicaid. Lack of reliable transportation limits ability to attend medical appointments, access prescriptions, and maintain preventive care, leading to worse health outcomes and potentially higher costs. Medicaid managed care organizations increasingly recognize non-emergency medical transportation (NEMT) as a critical social determinant of health requiring strategic intervention. Organizations are exploring enhanced NEMT benefits, partnerships with rideshare services, and integration of transportation coordination into care management protocols.

chcs.org

Managed Care·51d ago

CHCS Report Examines Long-Term Care Financing and Family Cost Burden

The Center for Health Care Strategies published a report analyzing long-term care financing in the United States, examining payment sources and financial strain on older adults and families. The report addresses who pays for long-term care services and why the current system creates significant cost burdens. Medicaid is the largest payer of long-term care services nationally, covering approximately 60% of nursing home residents and funding home and community-based services for individuals who meet financial and functional eligibility requirements. The analysis is relevant for managed care organizations operating long-term services and supports (LTSS) programs under Medicaid managed care contracts.

chcs.org

Managed Care·MA·79d ago

MassHealth Designs Primary Care Risk Adjustment Model for Population-Based Payment

MassHealth developed a primary care-specific risk adjustment model to support population-based payment arrangements with primary care practices. The model accounts for patient complexity factors relevant to primary care settings, distinct from traditional encounter-based or specialty-focused risk scores. The Center for Health Care Strategies published lessons learned from MassHealth's design process to inform other states and Medicaid managed care organizations implementing similar value-based payment structures. The work provides operational guidance for payers structuring capitation or shared savings arrangements with primary care providers.

chcs.org

State Policy·127d ago

CHCS Report Outlines State Medicaid Strategies to Expand CGM Coverage

The Center for Health Care Strategies published a report examining how state Medicaid programs can expand access to continuous glucose monitors for beneficiaries with diabetes. The report addresses coverage policies, prior authorization requirements, and reimbursement strategies that states can implement to improve glucose management technology access. It highlights disparities in diabetes outcomes among Medicaid populations and presents policy options for removing barriers to CGM adoption. The recommendations are relevant for managed care organizations responsible for implementing durable medical equipment benefits and managing diabetes care quality metrics.

chcs.org