This article focuses on some of the challenges that Medicaid payers (including states and managed care organizations) face when trying to establish alternative payment models with providers.

In recent years, CMS has implemented a variety of episode-based payment models. This paper provides a high-level guide to the unique and complex risk arrangements for providers under four of these models.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) represents a tectonic shift away from fee-for-service payment models. Milliman has developed a series of papers that examine the impacts of MACRA on providers and health plans.