Since the mid-1990s, many Medicaid programs have aggressively introduced managed care, which reconfigures service delivery using business principles. Most states have insufficient experience in developing managed care plans for Medicaid beneficiaries with disabilities. Middle-aged adults with physical ...
New York advocates issue warning on Medicaid managed care plans.Examines concerns regarding the impact of the planned introduction of six special-needs plans (SNPs) on managed care plans in the state of New York. Provision of services to 60,000 people with the most serious mental and emotional...
That’s the dilemma states are facing as they put more Medicaid patients into managed-care plans to cut costs. Bloomberg Government health-care policy analyst Christopher Flavelle looked at managed-care plans in the five most populous states, including New York and California. His Bloomberg Governm...
For more than 20 years, state and federal policy-makers have promoted Medicaid managed care as a way to improve access to good quality care for the Medicaid beneficiary, while at the same time containing (or at least stabilizing) costs. Capitated health plans would reduce relianceon expensive ...
can access information about Medicaid and CHIP eligibility and managed care, compare managed care plans based on quality, and select plans that best meet their needs. The rule also established the CMS framework, state requirements for the MAC QRS, and the process by which ...
States are required to set network adequacy standards (NAS) for Medicaid managed care plans to ensure adequate access to mental health (MH) care. We examined the association between NAS and MH care access (including any MH services, inpatient MH stays, outpatient MH visits, MH prescriptions, an...
Accordingly, this research examines the quality of Medicaid managed care and the effect of MLR and efficiency. The results show that, medical services efficiency has an insignificant (but negative) effect on the quality of care, which indicates that there may be room to improve medical services ...
Managed Care OrganizationsMedicaidMedicare AdvantageSpecial Needs PlansComplex Care PopulationsManaged Care OrganizationsMedicaidMedicare AdvantageSpecial Needs PlansComplex Care PopulationsManaged Care OrganizationsMedicaidMedicare AdvantageSpecial Needs PlansComplex Care PopulationsManaged Care OrganizationsMedicaidMedicare Ad...
Managed Medicaid plans need innovations to improve the value and efficiency of healthcare provided. To ensure they’re getting the best value, state Medicaid programs re-procure contracts with managed care payer groups on a perpetual basis — sometimes as frequently as every three years. S...
Physician attitudes toward the patients, while generally negative, do not keep them from participating in Medicaid. However, the type of patients in AHCCCS is related to physician satisfaction with the AHCCCS health plans, as is reimbursement. The study indicates differences in the reasons for ...