Bill > H0201

This bill amends Idaho's Medicaid provider payment law to establish minimum risk-sharing requirements for value care organizations (VCOs), which are healthcare providers paid based on the quality and value of their services. Specifically, the bill mandates progressively increasing risk-sharing levels for VCOs over four performance years: 40% starting July 1, 2026, increasing to 50% in 2027, 60% in 2028, and reaching 70% in 2029 and subsequent years. Risk-sharing in this context likely means these organizations will be financially responsible for a growing percentage of potential cost overruns or performance shortfalls. The bill is part of Idaho's ongoing efforts to transition from traditional cost-based reimbursement to value-based payment models in Medicaid, which aim to incentivize high-quality, efficient healthcare delivery. The legislation declares an emergency and will take effect on July 1, 2025, allowing healthcare providers and the state time to prepare for the new risk-sharing requirements. This approach is intended to align healthcare provider incentives more closely with patient outcomes and cost-effective treatment.

Health and Social Services

Health and Welfare Committee (H)

https://legislature.idaho.gov/sessioninfo/2025/legislation/H0201/