For those in healthcare. By those in healthcare.

What makes Medicaid important?

The U.S. healthcare system is undergoing a rapid transformation, the goal of which is to maximize value of the dollars spent on providing higher quality care with better outcomes to improve overall population health. While the trends associated with this transformation impact all payers and providers, it is Medicaid – the nation’s largest source of public health coverage – that is often taking the lead.

At $495.8 billion, Medicaid makes up 16 percent of total national healthcare expenditures and provides coverage for more than 70 million people. It is a primary source of funds for safety net facilities that serve low income communities, nursing homes and other long-term care organizations, and provides assistance to 10 million “dual-eligibles” who receive both Medicare and Medicaid benefits.

Medicaid’s continued expansion in services and beneficiaries has established the program as the engine driving payment and delivery system reform. As such, it is deeply embedded in a number of highly influential trends that are reshaping the U.S. healthcare system as a whole. These include the adoption of alternative payment models and the incorporation of quality incentive payments into both fee-for-service and managed care delivery systems – changes driven by the Centers for Medicare and Medicaid Services’ encouragement of states to establish value-based payment arrangements and expand covered services and beneficiaries.

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Cognosante, dual-eligibles, interoperability, Medicaid, Medicare, Population Health


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