Articles

What Could Behavioral Health Community Support Look Like in 2040?
By 2040, behavioral health community support in the United States could move beyond fragmented treatment episodes toward more continuous, personalized and recovery-oriented systems. This flagship analysis examines how Medicaid, crisis services, supportive housing, peer-led care, workforce redesign, digital technology and new payment models might reshape support for people with serious mental illness, substance use disorders and complex needs—and what providers, health plans and state agencies would need to make that future credible. Read more...
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 Outcomes-Based Contracting Mean for HCBS Providers?
Outcomes-based contracting could change how Medicaid-funded Home- and Community-Based Services providers are paid, evaluated and held accountable. This flagship analysis examines value-based payment design, state and managed care contracting, financial risk, workforce capacity, participant-defined outcomes and evidence requirements. It explores what providers need to negotiate, implement and govern arrangements that reward meaningful results without compromising access, choice or service sustainability. Read more...
Can Value-Based Payment Work in Community-Based Long-Term Services and Supports? Evidence, Incentives and Provider Sustainability
Value-based payment promises to connect Medicaid HCBS and LTSS funding more closely with quality, independence and outcomes, but community-based services face challenges that traditional healthcare payment models often overlook. This article examines federal and state policy, managed care contracts, outcome measurement, workforce costs, provider risk and practical payment design, showing when value-based arrangements can create genuine value and when they may undermine access and sustainability. Read more...
The Future of Managed Care Accountability in Medicaid HCBS and LTSS: Oversight, Quality, Access and Provider Performance
Managed care accountability in Medicaid HCBS and LTSS is moving beyond contract compliance toward stronger evidence of access, service continuity, participant experience and measurable outcomes. This flagship analysis examines federal and state oversight, managed care organization responsibilities, provider networks, authorization decisions, payment design, workforce sustainability, data integrity and corrective action, identifying what credible accountability should look like across increasingly complex community-based service systems. Read more...
Could Medicaid Move From Paying for Services to Paying for Independence? The Future of Outcome-Based HCBS Funding
Medicaid traditionally reimburses many community-based providers for authorized services and delivered units of support. But could future payment models reward greater independence, personal choice and sustained community living? This flagship analysis examines outcome-based HCBS funding, federal-state Medicaid architecture, managed care, provider economics, workforce incentives, quality measurement and safeguards against inappropriate service reduction. It explores how states and providers could develop payment arrangements that recognize meaningful progress without penalizing people with complex or lifelong support needs. Read more...
The Future of LTSS: Can Community-Based Care Keep Pace With an Aging America?
America's aging population is increasing pressure on long-term services and supports, but expanding community-based care requires more than shifting spending away from institutions. This flagship analysis examines Medicaid financing, HCBS capacity, workforce sustainability, managed care, family caregiving and the operational realities of aging at home. It explores how states, health plans and providers can build more resilient, equitable and accountable LTSS systems over the coming decade. 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...
Outcome Prediction Models in Adult Social Care Commissioning
Outcome prediction could change how U.S. community-based care systems evaluate services, allocate resources and identify where better outcomes may be achievable. This flagship analysis examines how Medicaid agencies, managed care organizations and providers can combine longitudinal, operational and person-reported evidence to forecast outcomes while protecting choice, equity and due process and avoiding the misuse of predictive models as automated eligibility or funding decisions. Read more...
Can Social Care Funding Become More Preventive Through Data Intelligence?
Social care and community-based funding often responds after demand, instability or crisis has already become visible. This flagship analysis examines how U.S. Medicaid agencies, managed care organizations, states and providers could use data intelligence to identify emerging need earlier, direct investment toward prevention and connect funding decisions with access, workforce capacity, equity, quality and measurable long-term outcomes. Read more...
The Future of Intelligent Commissioning: How Data Could Transform U.S. Community-Based Care
Commissioning decisions shape who receives support, which providers can sustain services and whether community-based systems can respond before capacity fails. This flagship analysis examines how U.S. Medicaid agencies, managed care organizations and other purchasers can use connected workforce, quality, access, utilization, provider and participant evidence to move toward more intelligent purchasing and oversight across HCBS, LTSS, IDD and behavioral health services. Read more...