We deploy analytics to support MCOs to identify the areas where they can best impact the quality and efficiency of care; expanding member access to high-value care; and enhancing member experience of care. Financially sustainable care delivery We help health systems that serve Medicaid beneficiaries...
This webcast features Kate Paris, Vice President of Policy & Advocacy at UnitedHealthcare Community & State, in conversation with Craig Kennedy, President and CEO of Medicaid Health Plans of America. They discuss the implications of Medicaid redetermination and how MCOs can help smooth ...
The research estimates that states would save $13 billion over 10 years, which would come from reductions in the capitation rate. The report also notes the benefits of the bill to managed care organiza...
Hospitals and Medicaid MCOs maximize this by agreeing to a state tax on themselves, which the state uses to ratchet up the federal funding. After multiplication, the money goes right back to these providers. …Stopping this wild spending growth requires fundamental reform to Medicaid’s financing....
Federal auditors have found that Medicaid managed care organizations (MCOs) denied, on average, one of every eight prior authorization requests in 2019, echoing recent concerns about similar denials for Medicare patients. The investigation was conducted in response, in part, to allegations in the ...
HHAeXchange serves as the state aggregator in several states and helps dozens of MCOs manage billions of dollars in Medicaid claims while achieving a high level of oversight, transparency, and efficiency.Your Trusted Industry Partner On an annual basis, HHAeXchange confirms more than 136 million vis...
We included capitated payments to account for services provided by MCOs.29 The total cost was an existing variable in the MAX data and was derived from each file in the TAF data. We adjusted costs for inflation using the Consumer Price Index.30 We also calculated age-adjusted and inflation-...
Finally, states should enhance oversight and accountability to ensure that behavioral healthcare providers and managed care organizations (MCOs) comply with requirements that benefit young people. For example, state leaders can create measures that providers and MCOs must meet, such as approval...
DHH has identified Dental Services claims (for Provider Type 27-Dentist: Provider Specialty 67-0ral Surgeon) that were inappropriately paid by Legacy Medicaid beginning with date of service 2/1/2015. These claims became the responsibility of the Managed Care Organizations (MCOs) effective 2/1/2015...
Star+Plusis a Medicaid Managed Care program of theTexas Health and Human Services Commission(HHSC) for adults who are not receiving Medicare. The term "Managed Care" means the State of Texas hires managed care organizations (MCOs) to manage your health care and theStar+Plusplan is one option...