Markets/Insurance
A state market where physical health remains state‑administered while select populations operate under managed care.
What is Idaho’s Medicaid delivery model?
IN THE PEACH STATE, LARGE PROVIDER SYSTEMS ARE REFERRED TO AS THIS. DON’T TELL YUL BRYNNER.
THE MAGNIFICENT SEVEN
What tool does the team use to track their deliverables?
What is the Task Planner?
Under Social Security Act Section 1905 and Affordable Care Act rules for Alternative Benefit Plans (ABPs), this traditionally “optional” Medicaid service becomes effectively required for expansion adults because it is included in the state’s chosen benchmark plan and must meet Essential Health Benefits (EHB) and actuarial value standards—limiting a state’s ability to eliminate it without a State Plan Amendment.
What is an optional Medicaid benefit that becomes effectively mandatory under an ABP/EHB benchmark (e.g., habilitative services or prescription drugs)?
The only mammal capable of true flight.
What is a bat?
A state that operates Medicaid managed care without a traditional competitive RFP process for its core program
What is Wisconsin’s BadgerCare Medicaid program?
IN FEBRUARY 1971, THE OSMONDS HIT NUMBER 1 WITH ONE BAD APPLE. MICHIGAN GAVE THREE MCOs “ONE BAD APPLE” IN ITS LAST HEALTH PLAN REPORT CARD (NAME AT LEAST ONE).
HAP CARESOURCE, CVS & MCLAREN
This landscape highlights race, ethnicity, and cultural considerations in vulnerable communities.
What is Poverty & Demographics Landscape?
For Medicaid Alternative Benefit Plans (ABPs) authorized under the Affordable Care Act, a state may reduce or eliminate an “optional” service like adult dental or vision, but only if this financial threshold—measured against the selected benchmark plan—is still met, ensuring the overall benefit package remains comparable in value.
What is actuarial value (AV)?
This sitcom character yells “Pivot!” while moving a couch.
Who is Ross Geller?
A Medicaid program requiring coordination across MCOs, a single pharmacy benefit manager, and a specialized children’s behavioral health plan.
What is Ohio’s Medicaid managed care structure?
IN JANUARY 2022, WISCONSIN HAD 14 OF THESE TO SERVE HEALTHCARE TO ITS RESIDENTS; IN MARCH 2026, IT HAD 10. SO FAR, ONLY GEORGE CONSTANZA IS UNCOMFORTABLE WITH THIS AMOUNT OF SHRINKAGE.
GEOGRAPHIC SERVICE REGIONS
This _____ product refined repeatedly to improve clarity, legibility, and leadership usability.
What is the Briefing Book?
Required for Medicaid expansion populations under the Affordable Care Act, these benefit packages must be based on a benchmark plan, cover all Essential Health Benefits (EHBs), and can include services that are traditionally “optional” under Social Security Act Section 1905—effectively redefining what states must cover for this population.
What are Alternative Benefit Plans (ABPs)?
This role offers expert insight and analysis alongside the play-by-play announcer.
What is a color commentator?
A fully integrated model combining Medicare and Medicaid benefits under a single plan
What is a FIDE‑SNP / Medicare‑Medicaid Coordinated Plan (MMCP)?
AT 57 PERCENT, THIS PIPELINE STATE’S HOSPITAL REIMBURSEMENT REMAINS AMONG THE LOWEST IN THE NATION. IF THIS WAS PENNSYLVANIA, THE PITT WOULD NOT SURVIVE.
Indiana
This ______ includes Market Briefing Books, BISA decks, poverty landscapes, and competitive insights.
What is the Market Insights Opportunity Toolkit?
Within Medicaid Alternative Benefit Plans (ABPs) authorized under the Affordable Care Act, a state may eliminate or scale back a traditionally optional service—like adult vision or chiropractic—but cannot reduce the overall benefit package below this requirement, which must remain actuarially equivalent to the selected benchmark and continue to cover all Essential Health Benefits (EHBs).
What is maintaining actuarial value equivalence to the benchmark plan (while preserving EHB coverage)?
This global K-pop group released hits like Dynamite and Butter.
Who are BTS?
Bonus Points-
"Q.U.E.S.T.", in the Hawaii QUEST Integration Medicaid program stands for.?
What is Quality care, Universal access, Efficient utilization, stabilizing Costs and Transforming the way health care is provided to members
Bonus Points-
IN OCTOBER 2025, OHIO GOVERNOR MIKE DEWINE NAMED SCOTT PARTIKA AS SUCCESSOR TO THIS LONGTIME MEDICAID DIRECTOR.
MAUREEN CORCORAN
Bonus Points-
CareSource was originally known by this name when it launched as a Medicaid-focused health plan in Ohio.
What is the Dayton Area Health Plan (DAHP)?
Bonus points-
In Indiana Healthy Indiana Plan (HIP), this version of the program includes enhanced “optional” benefits—such as adult dental, vision, and chiropractic—funded through POWER accounts, while the other version offers more limited coverage and may require copayments for these same services.
What is HIP Plus (compared to HIP Basic)?
Bonus Points-
Before Joe Burrow, this quarterback was the Bengals starter from 2011–2017.
Who is Andy Dalton?