Authorization to Inform the Redesign of Medicaid to Advance Delivery System Reform for Vulnerable Populations


As Medicaid's health coverage role has expanded, states have sought to use Medicaid's growing purchasing power to drive improvements in the care delivered to vulnerable populations. States have pursued multipayer reforms, value-based payment models, and various models for delivering behavioral health care, social services, and long-term services and supports. Medicaid has also become an integral source of financial support for safety-net providers. Alternative Medicaid financing strategies currently being considered as part of ACA repeal-and-replace proposals-including block grants and per capita caps-would likely decrease federal Medicaid funding to states, forcing difficult choices regarding coverage eligibility, benefits, payment rates, and services. As these proposals rapidly move forward, The Commonwealth Fund seeks to be positioned to inform the development of Medicaid policy options that will enable the program to continue to drive improvements in care delivery for vulnerable populations and sustainably fund the safety-net providers serving them. This authorization will enable the Fund to provide grants to: examine the potential impact of alternative Medicaid financing proposals on delivery system and payment reform and inform implementation options that would promote value in Medicaid; and assess the potential impact of proposals on safety-net funding and inform options for sustainable provider financing under a capped Medicaid funding structure. This authorization for Board-level grants will allow the Fund to respond in a timely manner to proposed Medicaid policy changes that have implications for delivery system reform and safety-net financing. Projects funded under the authorization will help policymakers identify the best approaches for meeting the needs of vulnerable populations.

Grant Details

Grantee Organization:
The Commonwealth Fund
Principal Investigator:
Pamela Riley, M.D., M.P.H.
Award Amount:
Approval Date:
April 11, 2017

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