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DSS advisory group debates fee-for-service, PMPM and shared‑risk options for Medicaid primary care
Summary
Department of Social Services officials and stakeholders reviewed Phase 2 design elements for a proposed Medicaid primary-care payment model, debating trade-offs between fee‑for‑service and population‑based payments, the role of flexible funds and community health workers, and next steps for technical design and budgeting.
The Department of Social Services convened an advisory group on April 4 to review Phase 2 work and to solicit feedback on a proposed Medicaid primary‑care payment model that blends fee‑for‑service (FFS), per‑member‑per‑month (PMPM) payments and quality‑based incentives.
Presenter (S2) told the group the meeting’s purpose was to “play back what we've heard with a, you know, a semi concrete, structure” for how an alternative payment model might work and to gather feedback. The proposal presented a high‑level framework with multiple tracks for providers and a set of cross‑cutting design elements, including member attribution, social and clinical risk adjustment, and a quality‑performance slate.
Debate centered on how much of the base payment should remain FFS versus be shifted to PMPM or partial capitation. A range of views emerged: some participants urged keeping FFS as the foundation and adding PMPM as targeted…
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