Freedman HealthCare is supporting several Medicaid and other state agency clients as they adapt to heightened federal oversight and evolving compliance expectations from the Centers for Medicare and Medicaid Services (CMS). Key trends we're observing:

• Stricter enforcement of existing requirements, particularly in Outcomes-Based Metrics reporting, CMS is now distributing standardized Excel workbooks to ensure consistent monthly updates.
• Increased scrutiny of program cost classifications, specifically the distinction between Design, Development, and Implementation (DDI) versus Maintenance and Operations (M&O) expenditures, requiring more precise documentation and justification. 
• Expanded contract review protocols. CMS is now requiring review and approval of all contracts related to previously approved federal match dollars, creating new layers of approvals that demand careful preparation and planning.

Our Freedman HealthCare consultants are well-positioned to help navigate these challenges by reviewing cost documentation and preparing materials for CMS review and approval. We understand the nuances of federal requirements and can ensure programs maintain their funding while meeting these enhanced standards.

Simultaneously, we're closely monitoring federal Artificial Intelligence (AI) priorities that may impact integrated data systems and program administration. The White House issued two critical memos in April 2025: "Accelerating Federal Use of AI through Innovation, Governance, and Public Trust" and "Driving Efficient Acquisition of Artificial Intelligence in Government." These directives signal a firm federal commitment to AI adoption in government-funded programs while emphasizing responsible implementation and streamlined procurement processes. The National Institutes of Health (NIH) also released a recent RFI on their AI Strategy (responses due July 15, 2025).

Freedman HealthCare will host a webinar on AI & Healthcare Data: Benefits and Concerns for States on Thursday, November 13, 2025, from 2:00 to 3:00 PM ET.

Join us for an interactive panel discussion on how AI can enhance All-Payer Claims Databases (APCDs) and Integrated Data Systems. Speakers will explore real-world applications of AI for staff training, operational efficiency, and advanced analytics, with a focus on realistic and relevant use cases for state-run data programs.

Register Now!

White House Memo: "Accelerating Federal Use of AI through Innovation, Governance, and Public Trust" (April 2025)

White House Memo: "Driving Efficient Acquisition of Artificial Intelligence in Government" (April 2025)

NIH AI Strategy RFI

To discuss ways in which AI can support your program – or to learn how other states are using AI – contact Tanya Bernstein at tbernstein@freedmanhealthcare.com

Evaluating Alternative Payment Models in Maryland

In 2024, Freedman HealthCare partnered with the Maryland Health Care Commission (MHCC) to evaluate the state’s progress in adopting Alternative Payment Models (APMs) across five key areas:

• Volume and types of value-based arrangements
• Quality outcomes achieved
• Complaints filed
• Cost-effectiveness
• Impact on practitioners’ fee schedules

The overarching goal of these efforts is to foster a transition from traditional fee-for-service payment models to systems that reward quality outcomes and patient-centered care.

The report found that APM adoption in Maryland increased significantly on a population basis, including growth in population-based and episode-based models. While participation in APMs increased, non-claims payments to providers—a critical component of advanced APMs—remained minimal in Maryland.

MHCC utilizes this report to inform future policy decisions and continually refines its data collection efforts, updating the report annually. Freedman HealthCare continues to advise and support data collection enhancements and reporting efforts.

For any questions, contact Gary Swan at gswan@freedmanhealthcare.com

Visualizing Maryland's Investment in Primary Care

In 2024, the Maryland Health Care Commission (MHCC) took a significant step toward strengthening primary care by reporting primary care investment data in its annual report and data supplement, including information by county, payer, and race. For 2025, MHCC aimed to make these findings more accessible and actionable through an interactive format.

Freedman HealthCare's program and data science teams are leading the design and visualization of a web-based dashboard published by the Maryland Health Care Commission (MHCC). The dashboard visualizes primary care spending across the state of Maryland. The dashboard draws from the Maryland Medical Care Database (MMCD) and the state’s All-Payer Claims Database, allowing users to explore primary care spending in Maryland by payer type, including commercial payers and Medicare Advantage payers.

The visualizations will display primary care spending as a percentage of total medical expenditures, allowing for the examination of trends over time. This new tool equips state leaders, advocates, and stakeholders with a clear and interactive way to monitor progress and track performance against Maryland’s primary care investment goals.

For any questions, contact Ena Backus at ebackus@freedmanhealthcare.com

California’s Office of Health Care Affordability Sets Hospital Spending Growth Target



In a significant move to curb rising healthcare costs, California’s Office of Health Care Affordability (OHCA) has established a hospital sector spending growth target aligned with the state’s Total Health Care Expenditure (THCE) benchmark. Beginning in 2025, the hospital spending target is set at 3.5%, signaling the state’s strong commitment to affordability.

Freedman HealthCare is proud to support OHCA in designing the hospital sector measurement methodologies behind this initiative. Our team conducted detailed technical analysis using hospital financial reports, facilitated engagement with key stakeholders, and helped shape the strategies behind the scenes. We assessed measurement options, examined potential impacts, and delivered policy recommendations to guide this landmark decision.

With the spending target now approved by the Health Care Access and Information Board, Freedman HealthCare continues to partner with OHCA, supporting data analysis, modeling, and turning measurement into action.

For any questions, contact Gary Swan at gswan@freedmanhealthcare.com

Delaware Health Care Claims Database: Standardizing Data Products

Freedman Healthcare is a long-time partner of the Delaware Health Information Network (DHIN) team to streamline and standardize access to Delaware's Health Care Claims Database (HCCD). Together, we are designing and implementing a Standard Limited Data Set (SLDS) that simplifies the data request and release process while ensuring compliance with HIPAA privacy standards.

The Standard Limited Data Set (SLDS) is designed to:

• Meet most research needs through a reliable, streamlined dataset
• Ensure HIPAA compliance and incorporate Delaware-specific financial and provider-level requirements
• Reduce administrative burden for researchers
• Provide comprehensive documentation, including guides and data dictionaries.

To support transparency and usability, each data release will be accompanied by clear, comprehensive documentation—including user guides, data dictionaries, and entity relationship diagrams—ensuring researchers can make the most of the SLDS.

The SLDS will also serve as the foundation for DHIN’s next data initiative: the development of public-use files and broadening access to healthcare data for a wide range of stakeholders.

For any questions, contact Janice Bourgault at jbourgault@freedmanhealthcare.com

California Health Care Payments Database: Data Access and Release Support

Freedman HealthCare supports the California Department of Health Care Access and Information (HCAI) in managing the Health Care Payments Database (HPD), the state’s All-Payer Claims Database. The HPD contains administrative claims and encounter data submitted by healthcare payers across California, providing a comprehensive resource for analyzing healthcare costs, utilization, and quality.

Through HCAI’s Data Access and Release Program, researchers and policymakers can request standard or customized datasets based on their specific research questions and analytical needs.

Since 2018, Freedman HealthCare has contributed subject matter expertise to the development and refinement of the HPD program. Our team assists with:

• Application review and technical guidance
• Ensuring alignment with statutory and regulatory requirements
• Supporting Data Release Committee operations
• Advising on policy development and stakeholder engagement

Freedman HealthCare will host a webinar, APCD Use Cases: Innovative State Examples, on September 11, 2025, at 2:00 pm ET. This session will feature examples of innovative APCD analytics and reporting that have helped shape health policy. Presenters from select APCD states will share key takeaways and lessons learned, followed by a discussion of future opportunities and audience Q&A.

Register Now!

The Data Release Program, launched in December 2024, and HCAI is accepting requests for HPD data through an online application process. For more information on the California HPD Data Release Program, visit: https://hcai.ca.gov/data/request-data/hpd-data-access-and-release/.



Data-Driven Health Care System Planning in Rhode Island



In 2024, Rhode Island Governor Dan McKee established a Health Care System Planning Cabinet to guide long-term planning, monitoring, and evaluation of Rhode Island’s entire system of care. The cabinet's mission: use data to drive informed decisions that ensure access to high-quality, affordable care for all Rhode Islanders--now and into the future.

Freedman HealthCare’s program and data science teams are proud to support this important initiative in partnership with the Executive Office of Health and Human Services (EOHHS). Freedman HealthCare led the development of the Data Center for Health Care System Planning, delivering interactive dashboards and visuals that underpinned the Cabinet’s Foundational Report.

Building on that momentum, Freedman HealthCare is continuing its work in 2025 by helping to implement key recommendations from the report. Our focus remains on creating robust data frameworks that provide actionable insights—particularly related to the financial health of the system and effective resource management—to support strategic planning across Rhode Island’s health care landscape.

For any questions, contact Ena Backus at ebackus@freedmanhealthcare.com.