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- Medicaid_managed_care abstract "Medicaid managed care Medicaid and additional services in the United States through an arrangement between a state Medicaid agency and managed care organizations (MCOs) that accept a set payment – “capitation” – for these services. The State pays the MCO a monthly premium to cover the services provided to a beneficiary. As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities. There are two main forms of Medicaid managed care, “risk-based MCOs” and “primary care case management (PCCM).” In a PCCM system, the State pays for services on a fee-for-service basis as well as a monthly fee to a contracted primary care provider to coordinate care for the beneficiary.Managed care delivery systems grew rapidly in the Medicaid program during the 1990s. In 1991, 2.7 million beneficiaries were enrolled in some form of managed care. Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care – mostly, traditional health maintenance organizations (HMO) and primary care case management (PCCM) arrangements. This amounted to 29 million beneficiaries, of which 19 million individuals were covered by fully capitated arrangements and 5.8 million were enrolled in Primary Care Case Management. By 2015, 39 States, including Washington D.C., had contracts with an MCO to serve at least some portion of their Medicaid population. Overall, more than half of all Medicaid beneficiaries receive care through an MCO plan, with the majority of beneficiaries being children and parents. MCO enrollment is likely to increase as many states rely on their MCO system to enroll newly eligible beneficiaries as they expand coverage according to Medicaid expansion provisions in the Affordable Care Act (ACA).During this time, states increasingly turned to health plans already serving the public coverage programs such as Medicaid and SCHIP to operationalize expansions of coverage to uninsured populations. States used health plans as a platform for expansions and reforms because of their track record of controlling costs in public coverage programs while improving the quality of and access to care.A variety of different types of health plans serve Medicaid managed care programs, including for-profit and not-for-profit, Medicaid-focused and commercial, independent and owned by health care providers such as community health centers. In 2007, 350 health plans offered Medicaid coverage. Of those, 147 were Medicaid-focused health plans that specialize in serving the unique needs of Medicaid and other public program beneficiaries. Over 11 million are enrolled in Medicaid focused health plans [1]. The National Council on Disability of the US in July 2015 reaffirmed the \"guiding principles of Medicaid Managed Care Plans\" in line with the Americans with Disabilities Act of 1990.In 2011, all states except Alaska, New Hampshire and Wyoming had all, or a portion of, their Medicaid population enrolled in an MCO. States can make managed care enrollment voluntary, or seek a waiver from CMS to require certain populations to enroll in an MCO. If states provide a choice of at least two plans, they can mandate enrollment in managed care.Healthy children and families make up the majority of Medicaid managed care enrollees, but an increasing number of states are expanding managed care to previously excluded groups, such as people with disabilities, pregnant women, and children in foster care. In 2003, Hudson Health Plan implemented a patient-specific pay for performance (healthcare) (P4P) model to increase immunization rates and diabetes care for Medicaid managed care recipients.".
- Medicaid_managed_care wikiPageExternalLink LinkClick.aspx?fileticket=z3irJLCga4E%3d&tabid=282&mid=1185&forcedownload=true.
- Medicaid_managed_care wikiPageExternalLink SHO-13-001.pdf.
- Medicaid_managed_care wikiPageID "24031496".
- Medicaid_managed_care wikiPageLength "9199".
- Medicaid_managed_care wikiPageOutDegree "16".
- Medicaid_managed_care wikiPageRevisionID "697768657".
- Medicaid_managed_care wikiPageWikiLink Alaska.
- Medicaid_managed_care wikiPageWikiLink Category:Managed_care.
- Medicaid_managed_care wikiPageWikiLink Category:Medicare_and_Medicaid_(United_States).
- Medicaid_managed_care wikiPageWikiLink Centers_for_Medicare_and_Medicaid_Services.
- Medicaid_managed_care wikiPageWikiLink Enhanced_Primary_Care_Case_Management_Program.
- Medicaid_managed_care wikiPageWikiLink Health_maintenance_organization.
- Medicaid_managed_care wikiPageWikiLink Health_policy.
- Medicaid_managed_care wikiPageWikiLink Managed_care.
- Medicaid_managed_care wikiPageWikiLink Medicaid.
- Medicaid_managed_care wikiPageWikiLink Nonprofit_organization.
- Medicaid_managed_care wikiPageWikiLink Patient_Protection_and_Affordable_Care_Act.
- Medicaid_managed_care wikiPageWikiLink Pay_for_performance_(healthcare).
- Medicaid_managed_care wikiPageWikiLink Primary_care_case_management.
- Medicaid_managed_care wikiPageWikiLink Public_Law_110-343.
- Medicaid_managed_care wikiPageWikiLink United_States.
- Medicaid_managed_care wikiPageWikiLink Wyoming.
- Medicaid_managed_care wikiPageWikiLinkText "Medicaid managed care".
- Medicaid_managed_care wikiPageWikiLinkText "Medicaid".
- Medicaid_managed_care wikiPageUsesTemplate Template:Citation_needed.
- Medicaid_managed_care wikiPageUsesTemplate Template:Reflist.
- Medicaid_managed_care subject Category:Managed_care.
- Medicaid_managed_care subject Category:Medicare_and_Medicaid_(United_States).
- Medicaid_managed_care comment "Medicaid managed care Medicaid and additional services in the United States through an arrangement between a state Medicaid agency and managed care organizations (MCOs) that accept a set payment – “capitation” – for these services. The State pays the MCO a monthly premium to cover the services provided to a beneficiary. As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities.".
- Medicaid_managed_care label "Medicaid managed care".
- Medicaid_managed_care sameAs Q6806246.
- Medicaid_managed_care sameAs m.07k7d_1.
- Medicaid_managed_care sameAs Q6806246.
- Medicaid_managed_care wasDerivedFrom Medicaid_managed_care?oldid=697768657.
- Medicaid_managed_care isPrimaryTopicOf Medicaid_managed_care.