The ACA increases states’ already significant purchasing power and provides new tools for delivery system improvements, thereby increasing states’ ability to purchase with an eye toward quality and efficiency.

*Milestone details:

*Full name: Use federal funding opportunities and the state’s purchasing power in Medicaid, CHIP, public employee insurance plans, and the exchange to promote quality and efficiency.

*Relevance to the ACA:

Medicaid expansions and opportunities to align and develop public and private insurance programs within the Exchange will expand states’ already large roles in the health care market. The ACA provides several funding streams. States, as health care purchasers, may seek to foster higher quality and more efficient care.

Funding for Medicaid demonstrations projects:

§2403 - Extends the Medicaid Money Follows the Person long-term care demonstration.

§2601 - Extends the Medicaid waiver demonstration projects for dual eligibles.

§2704 - Establishes a demonstration program to evaluate the use of bundled payments for integrated care of Medicaid beneficiaries.

§2707 - Creates a Medicaid demonstration project to provide payments to institution of mental disease for treatment of adult enrollees who require emergency stabilization.

Grants available to states to encourage health system reforms:

§2951 - Awards grants to states to create and improve upon benchmarks in maternal in child health.

§3504 - Awards grants to states or groups of states to support pilot projects that design, implement, and evaluate innovative models of regionalized, comprehensive, and accountable emergency care and trauma systems.

§4201 - Grants to State and local governmental agencies and community-based organizations for the implementation, evaluation, and dissemination of evidence-based community preventive health activities in order to reduce chronic disease rates, prevent the development of secondary conditions, address health disparities, and develop a stronger evidence-base of effective prevention.

§6703 - Provides grants to states agencies to bolster coordination within and to monitor and act on issues regarding abuse neglect and exploitation in long term care facilities and among the elderly.