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Medicaid’s emergence as a state-by-state lab for healthcare reform

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“It is one of the happy incidents of the federal system, that a single courageous state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country.”

–Supreme Court Justice Louis D. Brandeis, writing in 1932.

Across America state Medicaid programs and their contracting managed-care plansĀ  are incubators for innovative solutions addressing healthcare cost, quality and access issues. As a Modern Healthcare report notes, “The innovations include integration of primary care and behavioral health, telemedicine, accountable care, patient-centered medical homes and coordination of medical services with long-term-care services and supports.”

“Several states, including California, New Jersey, New York and Texas, also have delivery system reform incentive payment (DSRIP) programs, which are federally approved waiver programs in which federal Medicaid funding is used to create financial incentives for providers to pursue delivery-system reforms. Those reforms involve infrastructure development, system redesign and clinical-outcome and population-focused improvements.”


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