Coalition Shares Concerns with Value-Based Care Provisions in Medicaid SDP Rule

America's Essential Hospitals joined a coalition of health care organizations to express concerns about value-based care provisions in the Medicaid state directed payments rule in a July 21 letter to the Centers for Medicare & Medicaid Services (CMS). The coalition includes 24 organizations committed to aligning Medicaid payment policies with value for patients.

The letter discusses how the proposed rule's overly prescriptive application of Medicare-based limits will interfere with state efforts to advance value-based payment models that are tailored to Medicaid beneficiaries' unique needs. We ask CMS to preserve state and managed care organization flexibility, align Medicare-based payment limits with the process used in Medicaid fee-for-service, and refrain from limiting services not required by statute.

The following organizations have signed onto this letter:

• Alliance of Community Health Plans
• American Academy of Family Physicians
• American Medical Group Association
• American Nurses Association
• America's Essential Hospitals
• America's Physician Groups
• Association for Clinicians for the Underserved
• Association for Community Affiliated Plans
• Association of American Medical Colleges
• Catholic Health Association
• Children's Hospital Association
• First Focus on Children
• Health Care Transformation Task Force
• Leading Age
• Medicaid Group Management Association
• National Association for Behavioral Health
• National Association of Community Health Centers
• National Association of Pediatric Nurse Practitioners
• National Council for Mental Wellbeing
• National Healthcare for the Homeless Council
• National Rural Health Association
• Primary Care Collaborative
• Society of General Internal Medicine
• Vizient, Inc.

Contact Director of Policy Rob Nelb, MPH, at [email protected] or 202.585.0127 with questions.