Through summary descriptions and illustrative maps, America’s Essential Hospitals provides an overview of Medicaid alternative payment models (APMs) states use as platforms for better care and lower health care costs. These payment models vary widely in design, often building on a state’s existing payment framework and delivery pathway.
- States have increasingly sought to establish APMs for Medicaid.
- APMs build on a foundation of fee-for-service or managed care systems – or a mix of both.
- APMs typically leverage incentives to improve cost efficiency, coordination, and quality.
- Aligning Medicare and Medicaid payments and financing will be critical to improving care for dually eligible enrollees in APMs.