As Kansas shifts from a fee-for-service Medicaid program to managed care, a Kansas Health Institute News Service report delved into the effectiveness of Medicaid managed care by gaining perspectives from five states and the national level.
National
Christopher Flavelle, a healthcare policy analyst for Bloomberg Government, said in the report that after co-authoring three reports on Medicaid managed care, he has seen some persistent trends. "Some states have primarily for-profit managed care, some have primarily non-profit managed care, and some have a mix," he said. "There seems to be a pattern — and my research isn't the only body of work showing this — that for-profit seems to be lower performance on health outcomes."
Florida
Florida is expected to place 85 percent of its Medicaid beneficiaries into managed care plans by 2014. Some of the managed care stories resulted in happy endings, including one man who credited his Medicaid case manager for saving his life after a motorcycle accident left him severely impaired, and Florida is still in the process of refining its program to ensure care is coordinated efficiently.
Georgia
Georgia is in a similar position to Kansas, as it is looking to expand its Medicaid managed care to more enrollees, including the elderly and disabled. A consultant for Georgia recommended expanding managed care to cut more costs, and Cindy Zeldin, executive director of Georgians for a Healthy Future, said results have been mixed thus far, but "this is the direction that things are headed," according to the report.
Indiana
Indiana initially had five managed care companies controlling the care of Medicaid beneficiaries, but now it is down to three. David Roos, executive director of Covering Kids and Families of Indiana, said the push for managed care has caused some "very good people [in the industry] to get burned out" because it is such a tough market, according to the report.
Kentucky
Kentucky moved to Medicaid managed care last year, and although it is still in its infancy, some health advocates have said the transition "hasn't been smooth" thus far, as legislation and regulation of managed care organizations has been cumbersome.
Texas
Similar to the other states, there have been mixed results in Texas, as CMS just approved the state's managed care strategy this past December. Anne Dunkelberg, associate director of the Center for Public Priorities, said in the report Texas' managed care market is controlled by for-profit companies, but linking payments to performance is a positive sign within the Texas program.
National
Christopher Flavelle, a healthcare policy analyst for Bloomberg Government, said in the report that after co-authoring three reports on Medicaid managed care, he has seen some persistent trends. "Some states have primarily for-profit managed care, some have primarily non-profit managed care, and some have a mix," he said. "There seems to be a pattern — and my research isn't the only body of work showing this — that for-profit seems to be lower performance on health outcomes."
Florida
Florida is expected to place 85 percent of its Medicaid beneficiaries into managed care plans by 2014. Some of the managed care stories resulted in happy endings, including one man who credited his Medicaid case manager for saving his life after a motorcycle accident left him severely impaired, and Florida is still in the process of refining its program to ensure care is coordinated efficiently.
Georgia
Georgia is in a similar position to Kansas, as it is looking to expand its Medicaid managed care to more enrollees, including the elderly and disabled. A consultant for Georgia recommended expanding managed care to cut more costs, and Cindy Zeldin, executive director of Georgians for a Healthy Future, said results have been mixed thus far, but "this is the direction that things are headed," according to the report.
Indiana
Indiana initially had five managed care companies controlling the care of Medicaid beneficiaries, but now it is down to three. David Roos, executive director of Covering Kids and Families of Indiana, said the push for managed care has caused some "very good people [in the industry] to get burned out" because it is such a tough market, according to the report.
Kentucky
Kentucky moved to Medicaid managed care last year, and although it is still in its infancy, some health advocates have said the transition "hasn't been smooth" thus far, as legislation and regulation of managed care organizations has been cumbersome.
Texas
Similar to the other states, there have been mixed results in Texas, as CMS just approved the state's managed care strategy this past December. Anne Dunkelberg, associate director of the Center for Public Priorities, said in the report Texas' managed care market is controlled by for-profit companies, but linking payments to performance is a positive sign within the Texas program.
More Articles on Medicaid Managed Care:
Ohio Medicaid Gives Contracts Back to Molina, Centene
Georgia Considers Expanding Medicaid Managed Care
West Virginia Medicaid May Expand Managed Care