Through 2013 and into 2014, the nation’s Medicaid Directors have remained focused on steering their programs through a time of great transition. This change is twofold: on one hand, Directors are working towards implementing the Affordable Care Act (ACA) and, on the other, ensuring the long-term sustainability of their programs by addressing the significant challenges involved in health system transformation. For the most part, Directors are making this happen with substantial resource constraints that make the realization of implementation and transformation major undertakings.
Despite the new challenges, the core duties of Medicaid Directors remain the same: they work within tight budgets and seek to maximize the value of their dollar; they manage a multitude of relationships with different partners and stakeholders in order to leverage a complex system environment to bring services to beneficiaries; they are accountable to both state leaders and federal regulators for the activities and outcomes of their programs; and they continue to find ways to achieve quality outcomes with limited internal resources.
This year’s survey also demonstrates how Medicaid Directors are moving forward with an array of programmatic reforms that will reshape their programs for years to come. Payment and delivery system innovations like medical homes and episodic payment, expansions and value-based purchasing efforts within managed care, and integrated care for individuals dually eligible for Medicaid and Medicare were all identified by Directors as major priorities for their state fiscal year.
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