Health centers care for more than 1 in 6 Medicaid beneficiaries nationally - half of health center patients are Medicaid beneficiaries.
Adequate Medicaid (or Medi-Cal in California) payments are essential to Health Centers’ viability and ability to innovate.
Each health center’s unique, per-visit Medicaid payment is intended to cover the comprehensive set of services provided by the health center and covered by the Medicaid program. In addition to primary medical care, these services typically include dental, mental health, and pharmacy, and may also include services such as care management and health education.
Not only are health centers’ doors open to all, regardless of ability to pay or insurance status, they generate incredible value to the health care system. On average, health centers save 24% of health care costs per Medicaid beneficiary when compared to other providers.
Healthy Adult Opportunity (HOA) - Block Grants (January 2020)
"The Centers for Medicare & Medicaid Services (CMS) is announcing a new opportunity to support states with greater flexibility to improve the health of their Medicaid populations. The Healthy Adult Opportunity (HAO) emphasizes the concept of value-based care while granting states with extensive flexibility to administer and design their programs within a defined budget. This state opportunity will enhance the Medicaid program’s integrity through its focus on accountability for results and quality improvement, making the Medicaid program stronger for states and beneficiaries." - CMS, February 2020 • Healthy
CMS Resources
- Adult Opportunity (HAO) PPT Slides via CMS
- The State Medicaid Directors’ letter
- Healthy Adult Opportunity Fact Sheets
- Press Release
- Original Guidance Letter (2018)
Articles
- What Does New Block Grant Guidance Mean for the Medicaid Program?
- 5 Things To Know About Trump’s Medicaid Block Grant Plan
- Implications of CMS’s New “Healthy Adult Opportunity” Demonstrations for Medicaid
- Healthy Adult Opportunity: An Empty Promise from the Trump Administration
- The Trump Administration’s Medicaid Block Grant Guidance: Frequently Asked Questions
- Trump Administration Continues its Efforts to Explode Medicaid
General Medicaid Resources
- The Role of Medicaid Expansion in Care Delivery at Community Health Centers
- Nuts and Bolts of Medicaid
- Health Centers and Medicaid
- Health Centers, A Medicaid Success Story