Top 5 Milbank Memorial Fund Publications of 2023

Our top 5 most-read publications of 2023 (not including Milbank Quarterly articles) highlighted the need for better support for primary care and provided state-by-state guidance on how to set up a health care cost growth target program; such programs can provide states and their partners with insight into cost drivers and policies that will advance affordability. Other popular pieces covered Medicaid demonstrations in North Carolina and Massachusetts that are exploring innovative ways to provide social needs and comprehensive primary care, respectively. We hope you’ll check out or revisit these pieces.   

1. The Health of US Primary Care: A Baseline Scorecard Tracking Support for High-Quality Primary Care 

This first national primary care scorecard, co-funded by the Milbank Memorial Fund and The Physicians Foundation, found a chronic lack of adequate support for the implementation of high-quality primary care across the United States. Developed in collaboration with researchers at the American Academy of Family Physicians’ Robert Graham Center, the scorecard tracked baseline trend data for the nation and, when available, for states across four key dimensions: financing, access, workforce development, and research. State data is available in the data dashboard. The second scorecard will be released in February 2024.  

2. Making Health Care More Affordable: A Playbook for Implementing a State Cost Growth Target 

More and more states are building the infrastructure needed to make statewide health care spending transparent through cost growth target programs. This resource from the Peterson-Milbank Program for Sustainable Health Care Costs offers guidance on activities and steps required to implement a cost growth target. The playbook is informed by the experience of the states that receive technical assistance through program, as well as state experiences in Massachusetts and Delaware.  

3. Becoming Less Usual: Understanding the Decline in the Number of People with a Usual Source of Care 

People with a usual source of care (USC) — a health professional or care location where one can go if sick or in need of medical advice — report better health outcomes and a more positive experience with the health care system. But the number of people with a USC is declining. Using data from the nationally representative Health and Retirement Study, this report by Jane L. Tavares of the LeadingAge LTSS Center @UMass Boston and Marc A. Cohen of the LeadingAge LTSS Center and Community Catalyst examined recent trends, finding that people tend to either gain or lose a USC with major life changes, and that being a person of color and decreases in income were associated with higher odds of losing a USC. 

4. Addressing Social Needs through Medicaid: Lessons from Planning and Early Implementation of North Carolina’s Healthy Opportunities Pilots  

This report copublished with the Duke-Margolis Center for Health Policy offers findings and recommendations from the planning, capacity-building, and early implementation of North Carolina’s Healthy Opportunities Pilots, a comprehensive state Medicaid initiative that tests the impact of providing select non-medical services related to housing, food, and other social needs of eligible enrollees.  

5. How Massachusetts Medicaid Is Paying for Primary Care Teams to Take Care of People, Not Doctors to Deliver Services    

In this Q&A, Martha Farlow, director of policy for the Office of Payment and Care Delivery Innovation at Massachusetts’ Medicaid agency, and Ryan Schwarz, chief of the Office of Payment and Care Delivery Innovation, share insights on the implementation challenges of launching a value-based payment model for primary care providers participating in Massachusetts’ Medicaid’s accountable care organization program.