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States Focus on Primary Care in Medicaid Quality Improvement

A recent analysis by the Commonwealth Fund examined 36 state Medicaid quality strategies for advancing primary care.

As states seek greater value in Medicaid, many turn to managed care plans. Federal Medicaid law requires state managed care plans to offer Medicaid beneficiaries access to primary care. A state that contracts with managed care organizations (MCOs) must have written quality strategies outlining how it will use managed care to support and strengthen primary care.

According to the Commonwealth Fund’s review, states are explicitly focused on:

  • using managed care to improve primary care;
  • incorporating social determinants of health and coordinating medical and social services;
  • engaging patients using cultural competency; and
  • linking quality measures to provider payment incentives.

The analysis also provides details from state quality strategies, intended for state Medicaid program administrators who are considering updating their own strategies.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Kelcie Jimenez is a state policy analyst at America's Essential Hospitals.

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