Publications

This brief provides an overview of existing state, federal, and private sector hospital efficiency measures; the advantages and limitations of those measures; potential modifications to existing measures; and options for how states can employ new or existing measures to better understand current hospital efficiency levels and incentivize improved efficiency.   More

This report offers community health centers, their partners, policymakers, and others a place to start in addressing challenges to implementing value-based payment models, particularly as the safety net faces potential cuts in federal funding for Medicaid.  More

Abstract The United States ranks below peer nations on many measures of health status, health care access and quality, and health outcomes while…  More

In collaboration with the U.S. Department of Health and Human Services (HHS), the Milbank Memorial Fund convened the second of two virtual meetings in support of the multi-state Secretary’s Postpartum Maternal Health Collaborative.   More

This series of profiles highlights five states that are in different stages of enacting and implementing primary care spending targets, including early planning and coalition building; active efforts to engage state policymakers; and implementation or revision of an enacted state policy.   More

This 2025 Primary Care Scorecard spotlights the downward cycle of financing for primary care, describing how persistent challenges in primary care arise from insufficient investment (or in the case of training, misplaced investment) and a fee-for-service (FFS) payment model that rewards volume rather than continuous, whole-person care. This report highlights how these systemic financial issues not only undermine the effectiveness of primary care delivery but, more importantly, jeopardize the overall health of our communities in the following ways.  More

This report describes the experiences of states that have designed and implemented policies to pursue these multiple targets and gathers lessons from their experiences to inform future policy development. Interviews with state officials and a multi-state convening revealed the strategies states used to establish their targets and their experiences implementing them. Officials described challenges to implementation and efforts to overcome them.  More

The authors offer guidelines on designing successful value-based payment contracts for FQHCs and recommend action steps for CMS, state Medicaid agencies, and FQHCs that will enable more of these safety-net providers to participate in value-based care — and realize savings as well as improved quality for patients.  More

This report discusses states’ use cases for a standardized approach to measuring behavioral health spending and considerations for implementation, leveraging recommendations for a standard methodology published in a previous Milbank report.  More