Articles

From Pilots to Payment: How Could Evidence Change the Way Care Technology Is Funded?
Care technology pilots can demonstrate promising results without creating a sustainable route to reimbursement. This article examines how Medicaid agencies, managed care organizations, providers and technology partners could translate credible evidence into payment decisions across HCBS, LTSS, disability and behavioral health services. It explores outcome measurement, cost attribution, rate design, contracting, equity, governance and the operational conditions required to move beyond temporary innovation funding. Read more...
What Could the Next Generation of Medicaid HCBS Look Like? Funding, Workforce, Quality and System Redesign
The next generation of Medicaid Home- and Community-Based Services will depend on more than expanding access or introducing new payment models. This flagship analysis examines how federal policy, state administration, managed care, provider networks, workforce investment, person-centered outcomes and digital infrastructure could reshape HCBS, and what states, health plans and community providers need to demonstrate for reform to deliver sustainable improvements. Read more...
What Could Medicaid Purchasing and Community-Based Care System Design Look Like in 2040?
By 2040, purchasing community-based care could look very different from today’s mix of fee-for-service reimbursement, managed care contracts, waivers and grant-funded programs. This flagship analysis examines how Medicaid agencies, health plans, providers and communities could use better population intelligence, payment design, provider-market stewardship and accountability to build more preventive, person-centered and sustainable systems. Read more...
The Future of Market Shaping Through Predictive Analytics
Community-based care markets are often managed through evidence of what has already happened. This flagship analysis examines how predictive analytics could help Medicaid agencies, health plans and provider systems anticipate emerging capacity gaps, workforce pressures and changing population needs, then shape more resilient, equitable and responsive provider markets without allowing algorithms to determine individual access or provider opportunity. Read more...
Predictive Commissioning and the Future of Public Service Planning in U.S. Community-Based Care
Public service planning is moving beyond retrospective demand and expenditure toward earlier intelligence about need, capacity and system pressure. This flagship analysis examines how U.S. Medicaid agencies, managed care organizations and human services systems can use predictive commissioning to connect population need, provider capacity, workforce, funding, quality and equity while retaining accountable human judgment. Read more...
Using Handoff Failure Controls to Stop HCBS Rates From Missing Coordination Cost
HCBS rate models can underprice services when handoff failures are treated as isolated communication issues. This article explains how commissioners and providers can control coordination breakdowns, protect productivity, and evidence when rate assumptions do not reflect real delivery effort. Read more...
Using Participant Change Controls to Stop HCBS Rates From Missing Rising Support Needs
HCBS rate models can become inaccurate when participant needs change but pricing assumptions remain fixed. This article explains how participant change controls help commissioners and providers track rising support pressure, protect continuity, and evidence when rate assumptions need review. Read more...
Using Supervision Load Controls to Stop HCBS Rates From Underpricing Management Capacity
HCBS rate models can fail when supervision is treated as a fixed overhead rather than workload that changes with risk, staffing, geography, and service complexity. This article explains how supervision load controls protect quality, utilization, and rate evidence. Read more...
Using Case Closure Controls to Stop HCBS Rates From Misreading Lost Activity
HCBS rate models can become distorted when case closures are treated as normal turnover without checking why activity ended. This article explains how commissioners and providers can control closure evidence, protect utilization, and identify when rates are linked to avoidable service loss. Read more...
Using Staff Deployment Controls to Stop HCBS Rates From Overstating Available Workforce
HCBS rate models can fail when employed hours are treated as fully deployable service capacity. This article explains how staff deployment controls help commissioners and providers test real availability, protect continuity, and evidence rate assumptions that reflect live workforce use. Read more...
Using Service Interruption Controls to Stop HCBS Rates From Ignoring Continuity Risk
HCBS rate models can understate cost when interruptions are treated as isolated incidents rather than signs of fragile delivery. This article explains how commissioners and providers can control interruption evidence, protect continuity, and test whether rate assumptions still support stable service. Read more...
Using Waitlist Controls to Stop HCBS Rates From Hiding Unmet Demand
HCBS rate models can misread access when waitlists are treated as simple demand queues. This article explains how commissioners and providers can control waitlist evidence, test capacity gaps, and identify when rate assumptions are restricting service availability. Read more...