Medicaid Resource Guide

Topics: Medicaid, Reimbursement, Finance

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The single largest opportunity for responding to the Medicaid crisis can be found in new care management models. To support members in improving efficiency and innovating on the care delivery model with a specific focus on the needs of Medicaid patients, we’ve assembled our top Medicaid resources below.  View all Medicaid Resources.

For any questions or to share innovative approaches at your own organization, please contact us at

Access to Chronic Care Management

Community Care of North Carolina’s Transition to Accountable Care

Community Care of North Carolina began as an enhanced medical home for Medicaid patients. Now the program has over a million participants and saves the state millions each year.

The Medicaid Health Home

Explores next steps for organizations interested in pursuing health home status, resources for organizations building Medicaid health homes, and the anticipated impact of health homes on downstream hospital utilization.

Hospital Navigators Make Primary Care Connection, Reduce Avoidable Readmissions

The Bon Secours life coach program dedicates hospital staff to help high-risk, underinsured patients get the primary and preventative care they need to improve health outcomes and curb inappropriate trips to the ED.

Incorporating a Non-Clinical Care Team Member to Tackle High-Risk Patient Challenges

Massachusetts General Hospital added a non-clinical community resource specialist to its primary care team to minimize lost clinician time, curb inappropriate service utilization, and improve clinical outcomes.

Partnering to Relieve ED Pressure

Presents strategies to address the root causes of chronic disease to effectively improve patient outcomes while preventing costly ED visits.

Streamlining and Simplifying Care for Medically-Complex Children through the Medical Home

Profiles the impact of the University of Arkansas for Medical Sciences and the Arkansas Children’s Hospital's medical home program for medically-complex children.

Behavioral Health

Reducing Inappropriate ED Use for Pediatric Behavioral Health

Provides two key recommendations for hospitals and health systems seeking to better manage pediatric behavioral health volumes.

Elevate Perinatal Behavioral Health Care Quality with a Tailored Inpatient Program

An interview with Dr. Samantha Meltzer-Brody MD, MPH, psychiatrist and director of the UNC Perinatal Psychiatry Program, the first perinatal psychiatry inpatient unit in the US.

PACT Program for Severe Mental Health Conditions

Learn more about the Program of Assertive Community Treatment (PACT) program, one of the most successful treatment programs for mental health patients.

Revamp Your Approach to Behavioral Health Care

Outlines a new approach to behavioral health care, focused on timely detection, treatment at the most appropriate site of care, and regional collaboration.

Improve Ambulatory Behavioral Health Care Delivery through Monitoring and Coordination

Dr. Carl Clark, CEO of the Mental Health Center of Denver, discusses the behavioral health care continuum and the need for provider collaboration.

Dual Eligibles

Three Specialized Strategies for Effectively Managing Care of Complex, Elderly Patients

Discover three strategies for addressing the dual eligible population and review key implementation considerations for hospitals.

Expanding Opportunities for Providers to Coordinate Care for Dual Eligible Patients

The new Medicare-Medicaid Coordination Office has introduced a program that offers 15 states up to $1 million each to design innovative approaches for meeting the needs of dual eligible patients.

Reduce Unnecessary Hospitalizations of the Most Complex Patient Population

Identify the most common diagnoses for potentially avoidable hospitalizations and implement care protocols that reduce the number of inpatient admissions for these conditions.

Improve Care Coordination and Address Gaps in the Continuum

Nearly 40% of all hospitalizations for dual eligible patients are potentially avoidable. Learn strategies to improve care for this population to prevent such hospitalizations.


Responding to the Medicaid Crisis

Health Care Advisory Board members may host an expert onsite at your organization once a year for no additional charge. Gather your leadership team to hear our latest Medicaid research firsthand.