July 31, 2015
Medicaid Network Adequacy: A Proactive Approach to Ensuring and Demonstrating Compliance
Date: Wednesday, August 26, 2015
Time: 1 to 2 p.m. EDT
Medicaid managed care plans need to take a proactive approach to meet network adequacy requirements and demonstrate compliance to state regulators. Often that means more than just having the right network in place. It also means being able to identify and address potential problems before they negatively affect member access and trigger regulatory action.
During this webinar, HMA Principal Karen Brodsky (who previously oversaw managed care contracting for the state of New Jersey), discusses the warning signs state regulators look for when assessing the adequacy of a Medicaid managed care plan’s network. Brodsky will also outline some practical ways plans can get out in front of these potential problems – not only demonstrating compliance to regulators but also improving access and satisfaction for members.
Karen Brodsky, Principal, Health Management Associates
- Identify the warning signs of potential network adequacy issues and proactively fix problems before they affect member access and spark Medicaid agency inquiries.
- Understand which provider network access triggers are directly connected to access issues and which may not be related to network problems, yet still raise network compliance concerns.
- Assess the viability of partnerships with community groups to satisfy demand for providers that meet the needs of members with special needs.
- Improve communications with state agencies, providers, advocates and community-based organizations about the status of the provider network and how to work with the health plan if there is an access problem.
Who Should Attend
Executives of Medicaid managed care plans, including government contract directors, provider network directors, directors of vendor contracting, operations and credentialing experts, and integrated delivery system executives who manage provider networks serving Medicaid populations.