Should states continue to move towards Managed Care programs for Medicaid?

With 16 million people expected to be eligible under the new healthcare law, state governors are looking for a way to properly finance their Medicaid programs. Many are looking at Managed Care as the answer. Managed care programs will set up an established network of providers for the enrollees to use with set reimbursement rates to those doctors, hospitals and nursing homes enrolled.

However, hospitals, doctors and nursing homes are concerned with these new programs. For doctors and hospitals, the main fears are lose of local control and a decrease in significant amounts of money due to the patients they have to continue to treat but who are unable to pay for their procedures. But for the enrollees, the Managed Care Network provides access to hospitals and physicians who strive to provide the best preventative and primary care. These measures reduce the overall cost of healthcare in the first place.

What are some of the benefits for doctors and hospitals to be included in a Managed Care Programs?

Source

The 19th Annual Medicaid Managed Care Congress takes place next week in Baltimore, Maryland.  Join other states and Medicaid Managed Care experts to help you catch up with the industry as well as gather knowledge to create a managed care program for your state.  Download the brochure here for more information and register to join us today!

Who will you Nominate for the Inaugural Medicaid Managed Care Innovation Awards?

The Medicaid Managed Care Congress is pleased to announce the inaugural Medicaid Managed Care Innovation Awards. This year, in honor of CMS's new Center for Medicare and Medicaid Innovation, we are looking to honor innovators in the Medicaid Managed Care sector, and we need your help to select the nominees. We are looking for innovators in the following categories:

• -State Medicaid Innovation Award
• -Medicaid Health Plan Innovation Award
• -Lifetime Medicaid Innovation Award

To find out more about the qualifications and nominate a company/state for an award, visit the MMCC Awards Page.

Due to the overwhelming response, the deadline for submission has been extended to Friday, April 8. Voting will be onsite at the 19th Annual Medicaid Managed Care Congress and the awards will be presented on the final day of the event.

Medicaid Managed Care Congress: Day 2

As Day 2 beings at the Medicaid Managed Care Congress, with a keynote from Senator Tom Daschle.

Senator Tom Daschle kicked off the meeting this morning with a wonderful keynote. He sketched out the Obama administration’s strategy for achieving healthcare reform. He believes that there is a 50-50 shot at significant reform this year and suggested that although health plans are apprehensive about a public plan that this option may serve as a safety net for the numbers of chronically ill not currently covered under traditional Medicare or Medicaid. In addition, he emphasized the continued need for a plan to reform long term care system. Is should focus not only through financial and access issues but also to the pool of primary care providers. As Americans looks to reform the system, policy makers must look to invert the pyramid that exists and move from a sick care based system to a system based on prevention by enriching the pool of quality primary care nurses and physicians to better support a system focused on wellness and prevention.

Medicaid Managed Care Congress: Day 1 Workshops

Afternoon workshops open with great group on never events, “Implementing a Comprehensive Never Event Reduction Program to Track, Report and Reduce the Occurrence of Never Events” it is an iterive process it being managing never events for hospital acquired conditions

The other workshop, “Waste, Fraud, and Abuse Identification and Reduction,” encouraged over 50 people to share strategies for managing waste fraud and abuse identification and reduction. We found this statement,”With any new strategy or policy people need to think about the unintended consequences,” to be very insightful. What do you think?