December 9, 2015
In “The Value of Medicaid Managed Care,” HMA authors Lisa Shugarman, Jaimie Bern and Jessica Foster review the literature describing the evolving Medicaid delivery system, focusing specifically on the growth of Medicaid managed care in the form of comprehensive risk-based managed care (RBMC) organizations. The paper, prepared for United HealthCare, also explores the role of Medicaid RBMC relative to the fee for service (FFS) delivery system and draws comparisons of the experience of these delivery systems from the perspective of the Medicaid beneficiary, the provider, and the state.
The paper concludes by sharing lessons learned from the last decade of Medicaid managed care expansion, including:
- Planning and implementation
- Stakeholder engagement
- Procurement approaches
- Outreach and enrollment
- Contract management and monitoring