AMERICAN INSTITUTE FOR VALUE-BASED CARE
Back to Medicaid and Value-Based Care

Module 1

How Medicaid Works

Medicaid is a federal-state partnership run separately in every state. Who it covers, how it is financed, and why value-based care looks different here.

4 lessons About 20 min

By the end of this module, you will be able to:

  • Explain how Medicaid divides financing, governance, and administration between federal and state government
  • Identify which Medicaid populations account for most of the program's spending
  • Describe how the federal match works and why its open-ended structure shapes state incentives
  1. The Federal-State Partnership Medicaid is not one program but a federal-state partnership run separately in every state. This lesson explains the structure that shapes everything else. About 5 min
  2. Who Medicaid Covers Medicaid covers very different people through different pathways, and a small group drives most of the spending. That imbalance shapes every value-based strategy. About 5 min
  3. How Medicaid Is Financed The federal match, capped by no dollar limit, drives Medicaid's politics and its value-based math. This lesson explains the FMAP and why it matters. About 5 min
  4. Why Value-Based Care Looks Different in Medicaid Everything the intro course taught still applies, but four features of Medicaid, churn, social need, low rates, and safety-net dependence, change the design. About 5 min

Module quiz

Answer all questions to see your score.

1. Why is it more accurate to say there is 'no single Medicaid program'?

2. People eligible on the basis of age or disability are what share of Medicaid enrollment and spending?

3. What is distinctive about the federal Medicaid match (FMAP)?

Next: Module 2, Medicaid Managed Care