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CENTER FOR

Medicare & Medicaid Design Solutions

At Healthsperien, we believe that individuals navigating Medicare, Medicaid, or both deserve care that is seamless, coordinated, and centered on their whole person needs.

The Center for Medicare & Medicaid Design Solutions is dedicated to transforming public programs integrating financing, delivery, and accountability to improve quality, strengthen coordination, and support responsible, scalable innovation. Our work helps leaders create systems where people experience continuous, connected care rather than fragmented programs, which enables health plans, providers, and states to deliver better outcomes and create smarter spending.

Our Focus Areas

Medicare–Medicaid Integration

Designing and advancing models that align financing and delivery across programs to reduce fragmentation and enhance patient centered outcomes.

Alternative Payment Models & Demonstrations

Developing and informing CMMI and state-led payment models that incentivize quality, innovation, and value.

Behavioral Health, Primary Care & Social Needs Alignment

Strengthening coordinated approaches that connect medical, behavioral, and social supports to improve quality and manage total cost of care.

Governance, Implementation & Performance Infrastructure

Building roadmaps, governance structures, and performance dashboards that make accountable, integrated care operational and sustainable.

Our Approach

We collaborate with health plans, providers, state agencies, innovators, and multi-stakeholder coalitions to design practical, scalable solutions. Our team blends deep policy expertise with operational experience to translate integration goals into actionable models and measurable results. Through evidence-driven strategies, iterative design support, and strong partnerships, we help organizations navigate complexity, align incentives, and build systems where care is coordinated, and accountability is shared.

Reach out to learn how the Center can support your work and help shape a future where Medicare and Medicaid systems work together to deliver seamless, high-quality, person-centered care.

Reach out for more information at info@healthsperien.com

Resources

May 19, 2026

Policy Prescriptions Episode 3: Value-Based Care Explained | The Future of ACOs, Medicare & Healthcare Policy

In this episode of Policy Prescriptions, Gary Jacobs sits down with Aisha Pittman, Senior Vice President of Government Affairs at National Association of ACOs, and Ray Quintero, Managing Partner at Healthsperien, for a deep conversation about the future of healthcare policy, Medicare reform, and accountable care organizations (ACOs). They break down how value-based care works, why fee-for-service medicine creates problems, and how new models like ACO LEAD are reshaping the health care system.
April 21, 2026

Policy Prescriptions Episode 2: From Isolation to Connection: The Policy Fix We’re Missing | SXSW Live

In this episode of Policy Prescriptions, Gary Jacobs sits down with health care policy leaders Andrew MacPherson and Tom Koutsoumpas to break down what lobbying actually is, how it works, and why most people misunderstand it.
April 12, 2026

Key Takeaways from AHIP’s 2026 Medicare, Medicaid, Duals and Commercial Markets Forum

CMS recently released a letter to State Medicaid Directors that provides implementation guidance for the requirement that states redetermine eligibility for Medicaid expansion adults every six months instead of annually, beginning in 2027.
April 2, 2026

Policy Prescriptions Episode 1: The Truth About Lobbying in Washington

In this episode of Policy Prescriptions, Gary Jacobs sits down with health care policy leaders Andrew MacPherson and Tom Koutsoumpas to break down what lobbying actually is, how it works, and why most people misunderstand it.
February 3, 2026

Employer Experiences Managing Prescription Drug Benefits and Partnerships with PBMs

Client Pharmaceutical Care Management Association (PCMA) Dates November 2025 –
February 3, 2026

Action for Progress Launches a New National Commitment to Behavioral Health and Addiction Care

Former U.S. Representative Patrick J. Kennedy has been named as a Partner with the firm and will establish and lead a new national mental health and addiction policy practice. Rep. Kennedy will bring his decades of national leadership, advocacy, and expertise in mental health to advise a diverse array of clients, focusing on mental health and addiction, community-based services and supports, and the need for health system transformation.
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Points of Contact

News

Policy Prescriptions Episode 3: Value-Based Care Explained | The Future of ACOs, Medicare & Healthcare Policy

May 19, 2026

Policy Prescriptions Episode 2: From Isolation to Connection: The Policy Fix We’re Missing | SXSW Live

April 21, 2026

Key Takeaways from AHIP’s 2026 Medicare, Medicaid, Duals and Commercial Markets Forum

April 12, 2026

Policy Prescriptions Episode 1: The Truth About Lobbying in Washington

April 2, 2026

Employer Experiences Managing Prescription Drug Benefits and Partnerships with PBMs

February 3, 2026

Action for Progress Launches a New National Commitment to Behavioral Health and Addiction Care

February 3, 2026

New Federal Guidance on 6-month Redeterminations for Medicaid Expansion Adults is a Big Operational and Policy Shift

January 23, 2026

Signals for Medicare Advantage: Key Takeaways from the Better Medicare Alliance Health Executive Policy Summit

January 23, 2026

Healthsperien’s What to Watch in Health Policy for 2026​

January 23, 2026

Andrew MacPherson, Founding Principal and Managing Partner of Healthsperien, has been appointed to the Board of Directors of the Elisabeth Kübler-Ross Foundation

January 23, 2026
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Contact Us Today

Healthsperien, LLC, is a Washington, D.C.-based health care policy consulting firm focused on strategic, regulatory, legislative and implementation issues.