While social determinants of health (SDOH) have been a topic of much discussion and a driver toward understanding and furthering health equity, definitions and approaches vary across the healthcare spectrum.
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Missouri Releases Medicaid Managed Care RFP
This week our In Focus reviews the Missouri MO HealthNet (MHD) Medicaid Managed Care Program request for proposals (RFP), released on November 19, 2021, by the Department of Social Services (DSS). The MHD managed care program serves about 850,000 Medicaid and Children’s Health Insurance Program (CHIP) members including the state’s newly implemented Medicaid expansion population, across all regions of Missouri. Missouri’s General Plan managed care program covers TANF, CHIP, expansion and similar eligibility groups but does not include individuals with disabilities or those over age 65. The RFP also contains a separate section for a single, statewide Specialty Plan for foster children and children receiving adoption subsidy assistance. Managed care organizations must bid on and win a General Plan contract in order to be eligible for the Specialty Plan contract.
HMA report compares quality outcomes across state Medicaid program delivery models
A recently completed analysis of the impact of Medicaid managed care on key quality indicators found managed care organizations (MCO) outperformed fee-for-service (FFS) and primary care case management (PCCM) programs for both Child and Adult Core Set measures, once the data was normalized with respect to beneficiary distribution in each model.
HMA report compares quality outcomes across state Medicaid program delivery models
A recently completed analysis of the impact of Medicaid managed care on key quality indicators found managed care organizations (MCO) outperformed fee-for-service (FFS) and primary care case management (PCCM) programs for both Child and Adult Core Set measures, once the data was normalized with respect to beneficiary distribution in each model.
Former CMMI director joins HMA, will help lead Medicare team
Amy Bassano, former deputy director for the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services, has joined national healthcare consulting firm Health Management Associates (HMA), taking the helm as a managing director of Medicare services.
Rhode Island Releases Medicaid Managed Care RFQ
This week our In Focus reviews the Rhode Island Medicaid managed care request for qualifications (RFQ), released on November 12, 2021, by the Executive Office of Health and Human Services (EOHHS). Contracts are worth approximately $1.4 billion annually and cover over 300,000 individuals.
Former South Dakota Medicaid Director Joins Leavitt Partners, an HMA Company
Bill Snyder, former South Dakota Medicaid director, has joined Leavitt Partners, an HMA Company as a principal with the firm. He is the third former Medicaid Director to join the Health Management Associates (HMA) family of companies this year.
Minnesota Releases Senior Health Options, Special Needs Basic Care RFPs
This week our In Focus reviews Minnesota Department of Human Services (DHS) requests for proposals (RFPs) for two of the state’s Medicaid managed care programs: Minnesota Senior Health Options/Minnesota Senior Care Plus and Special Needs BasicCare/Integrated Special Needs BasicCare. Both RFPs, released on October 25, 2021, cover health care services in all 87 Minnesota counties.