Past Projects

Fund Sends Letter about DSRIP Meeting to CMCS

June 30, 2016

In early June, the Fund was in contact with Eliot Fishman, PhD, of the Center for Medicaid and CHIP Services (CMCS). Christopher Koller, Fund president, and Jane Beyer, a Fund program officer, had the opportunity to share observations about a meeting held earlier in the year, in which six states who have or are applying for Delivery System Reform Incentive Payment (DSRIP) waivers came together to speak with Medicaid managed care organizations from their states.

The meeting provided an opportunity to identify and explore key issues related to the role of Medicaid managed care organizations in state DSRIP initiatives. A letter to Dr. Fishman summarizing the meeting and issues of concern to both state Medicaid Agencies and Medicaid Managed Care Organizations can be found here.

The Role of MCOs in DSRIP Implementation—Six States Meet to Discuss2014_march_meeting

April 19, 2016

In March, the Milbank Memorial Fund brought together officials from six states to talk about the role of managed care organizations (MCOs) in state Delivery System Reform Incentive Payment (DSRIP) projects.

DSRIP, a Medicaid delivery system reform initiative, is a component of Section 1115 Medicaid demonstration waiver programs, providing states with funds that can be used to support hospitals, other providers, and communities in changing how they provide care to Medicaid beneficiaries. DSRIP initiatives are tied to defined performance metrics, such as meeting core milestones for provider capacity building and population health or clinical improvements.

The meeting came about at the suggestion of the Association for Community Affiliated Plans (ACAP), an association representing ACAP Medicaid managed care plans. Leaders of state Medicaid agencies agreed that it was useful to meet, and the Fund facilitated agenda development and the meeting itself.  Read more

Private Market Options for Medicaid


As states decide whether and how to implement Medicaid expansion under the Affordable Care Act, much attention has focused on those states that are expanding coverage by using private funds in new ways.  In 2013, the Reforming States Group and the MMF held a state-to-state technical assistance meeting (click here for more information about these) for nine states interested in learning from three states about ways to use available ACA funds to enroll more people in Medicaid.

A second, one-on-one convening took place between Arkansas and Montana. Arkansas’ approved Medicaid waiver places almost all their Medicaid population in the commercial insurance market, except for a small group of people with complex medical conditions. Arkansas’ program, an interesting example of providing the same coverage to people of different income levels, was of particular interest to other states.

State Innovation Model (SIM) Test State Convenings


In 2013, the MMF and the Center for Health Care Strategies (CHCS) convened a meeting for representatives from six State Innovation Model test states, the Center for Medicare & Medicaid Innovation, and NORC at the University of Chicago, to identify common issues and potential solutions facing these states. A wide range of issues were discussed, but two areas of opportunity stood out for the test states at the meeting . These two areas also are likely to be of great interest to SIM design states and others looking to undertake multi-payer health care transformation in the coming year: (1) engaging all payers in common/aligned payment reform, and (2) integrating a broader array of providers across care delivery. While these two broad categories are familiar to stakeholders already engaged in multi-payer work, states honed in on a few new issues that are highly salient for all states interested in transforming their health systems. These issues were covered in two issue briefs.

The MMF continues to work with SIM test and design states as they develop and implement he State Health Innovation Plans required under the SIM program.