Managed Care

On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP). This document discusses how the final rule will strengthen the fiscal integrity of Medicaid and CHIP managed care.

On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP).The final rule contains several provisions designed to strengthen states’ delivery system reform efforts and support local priorities and initiatives while ensuring quality of care for Medicaid beneficiaries.

On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP)This final rule updates the options available to states and Medicaid and CHIP managed plans to communicate with beneficiaries.

On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP). The rule, which is the first overhaul of Medicaid and CHIP managed care regulations in more than a decade, advances the Administration’s efforts to modernize the health care system to deliver better care, smarter spending, and healthier people.

The Milbank Memorial Fund released a new study, the Role of State Medicaid Directors: A Leadership Imperative. This study was authored by Andy Allison, a former Kansas and Arkansas Medicaid Director. The study focuses on the current climate of Medicaid policy, organizations and leadership. There is a specific focus on how the administration is structured for Medicaid in the states and the adequacy of state investments in the role and compensation of these leaders.

The results of the annual survey represent a snapshot of the current status of state government employees, the agencies that administer the programs, and the services that are provided. The 2015 survey revealed that states are continuing to address the same underlying challenges discussed in the previous reports.The report also includes summary tables that outline specific information about each individual state agency and LTSS program. Email adiaz@advancingstates.org to request a hard copy version.

The white paper examines the impact that managed care organizations can have on cost and quality of care for older adults and people with disabilities. The National Council on Disability found that MCOs can lower the costs of services for these populations. However, MCOs must face the challenge of training staff on person-centered planning and competency for the quality of care to genuinely increase. This provides an analysis of the positives and negatives of MCOs and where to move from here.

The AARP Public Policy Institute released a new report conducted by Truven Health Analytics. The two part study examined Medicaid Managed Long Term Services and Supports program contracts in 18 different states for older adults and people with physical disabilities and case studies of new care coordination models in Ohio and Illinois. The findings indicate that states need care coordination and that these care coordinators provide crucial support for consumers and their family caregivers.

The U.S. Department of Health and Human Services report and the white paper commissioned by the National Interprofessional Initiative on Oral Health both examine the wide disparities in oral health due to lack of access. The U.S. fails to provide proper access for ongoing and preventative oral health care needs. A push must be made to integrate dental care as a component of primary care. There is also a focus on the impact and burden of oral diseases and their effect on quality of life.

Adult day services (ADS)--a non-residential service provided outside an individual's home for less than a full day--provides direct care to older adults and younger adults with physical disabilities. This report provides information about each state's approach to regulating this key community service. The report details different models, forms of regulation, and funding sources used by states to run ADS programs.