Briefing Detail Page
Medicaid Innovations: Can Managed Care Cut Costs and Improve Value?
Friday, October 28, 2011
According to a recent survey, a number of states have expressed interest in expanding managed care approaches within their Medicaid programs. But while managed care may present an opportunity for better delivery of care, it presents challenges within certain populations and geographic areas.
What are the different models for managed care within the Medicaid program? How many states are planning Medicaid managed care expansions? What impact would these changes have on beneficiaries, providers and health plans? What have we learned from past efforts to expand managed care? Are Medicaid managed care plans assuring the delivery of quality care? Are they effective for high-need, high cost populations? Or are they better suited to serve younger, healthier people? Will the provider networks be adequate to serve increasing numbers of beneficiaries? How are states planning to use managed care to prepare for 2014, when 16 million newly qualified beneficiaries begin enrolling in Medicaid as authorized by the Patient Protection and Affordable Care Act?
To address these questions and more, the Alliance for Health Reform and the Centene Corporation sponsored an October 28 briefing. Panelists were: Vern Smith, Health Management Associates; Judy Feder, Georgetown University; Ian McCaslin, Missouri Department of Social Services; Matt Salo, National Association of Medicaid Directors; and Dr. Mary Mason, chief medical officer of the Centene Corporation. Deanna Okrent of the Alliance moderated.
Deanna Okrent, Alliance for Health Reform, Moderator
Vernon Smith, Health Management Associates, Speaker
Ian McCaslin, MO HealthNet, Speaker
Matt Salo, National Association of Medicaid Directors, Speaker
Mary Mason, Centene Corporation, Speaker
Judy Feder, Georgetown Public Policy Institute, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)
|Transcript, Event Summary and/or Webcast and Podcast|
Transcript: Transcript (Adobe Acrobat PDF), 10/28/2011
Event Summary: Event Summary (Adobe Acrobat PDF), 10/28/2011
Full Webcast/Podcast: Medicaid Innovations: Can Managed Care Cut Costs and Improve Value?
|The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.
Mason Presentation (PowerPoint), 10/28/2011
Smith Presentation (PowerPoint), 10/28/2011
Feder Presentation (PowerPoint), 10/28/2011
McCaslin Presentation (PowerPoint), 10/28/2011
(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)
Materials List (Adobe Acrobat PDF), Alliance for Health Reform, 10/28/2011
Agenda (Adobe Acrobat PDF), Alliance for Health Reform, 10/28/2011
Sourcelist (Adobe Acrobat PDF), Alliance for Health Reform, 10/28/2011
Speaker Bios (Adobe Acrobat PDF), Alliance for Health Reform, 10/28/2011
Event Summary (Adobe Acrobat PDF), Alliance for Health Reform, 10/28/2011
|Offsite Materials (briefing documents saved on other websites)|
Stressed States Open Doors to Medicaid Managed Care, Managed Care Magazine, 3/1/2011
- Carroll, John
Innovative Medicaid Initiatives to Improve Service Delivery and Quality of Care: A Look at Five State Initiatives, Executive Summary, Kaiser Commission on Medicaid and the Uninsured, 9/1/2011
- Devers, Kelly, Robert Berenson, Terri Coughlin and Juliana Macri
Refocusing Responsibility For Dual Eligibles: Why Medicare Should Take the Lead, The Urban Institute, 10/1/2011
- Feder, Judy, et al.
States Are Limiting Medicaid Hospital Coverage in Search For Savings, Kaiser Health News, 10/24/2011
- Galewitz, Phil
States Pushing Managed Long-Term Care For Elderly and Disabled Medicaid Patients, Kaiser Health News, 2/22/2011
- Galewitz, Phil
A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey, Kaiser Commission on Medicaid and the Uninsured, 9/1/2011
- Gifford, Kathleen, Vernon K. Smith, Dyke Snipes and Julia Paradise
GOP Govs Unveil Medicaid Reform Principles, Republican Governors Association, 6/13/2011
Changing the way we receive medical care, Chicago Tribune, 8/26/2011
- Graham, Judith
Desperately Seeking Savings: States Shift More Medicaid Enrollees To Managed Care, Health Affairs, 1/1/2011
- Iglehart, John K
Eight Key Lessons for Managing Care in Medicaid in 2011 and Beyond, Center for Health Care Strategies, Inc., 5/7/2011
- Martin, Lorie
Effects of a Pregnancy Management Program On Birth Outcomes in Managed Medicaid (Adobe Acrobat PDF),Managed Care Magazine, 4/1/2011
- Mason, Mary V., et al.
Conn. has big Medicaid change in works, The New Haven Register, 2/9/2011
- O’Leary, Mary E.
Report to the Congress: The Evolution of Managed Care in Medicaid, Medicaid and CHIP Payment and Access Commission, 6/1/2011
For Governors, Medicaid Looks Ripe for Slashing, The New York Times, 1/28/2011
- Sack, Kevin
Section 4108 of the Affordable Care Act: Medicaid Incentives for Prevention of Chronic Diseases (Adobe Acrobat PDF),Center for Health Care Strategies, Inc., 3/1/2011
Managed care explained: Why a Medicaid innovation is spreading, Stateline, 5/31/2011
- Vestal, Christine
Insurers See Growing Risks As Well As Revenues in Medicaid Managed Care, Kaiser Health News, 8/29/2011
- Weaver, Christopher
Chapter 6: Medicaid Managed Care, Texas Health and Human Services Commission, 1/1/2011
- from Texas Medicaid and CHIP in Perspective
Assessing the Financial Health of Medicaid Managed Care Plans and the Quality of Patient Care They Provide, The Commonwealth Fund, 6/1/2011
- McCue, Michael J. and Michael H. Bailit
Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends, Kaiser Commission on Medicaid and the Uninsured, 10/26/2011
Dr. Mary Mason, chief medical officer and senior vice president of the Centene Corporation, discusses how managed care can help lower costs, improve care and prevent medical problems. From the Oct. 18 briefing cosponsored by Centene. (10 min.)
Vernon Smith of Health Management Associates explains that Medicaid managed care provides certain benefits that fee-for-service Medicaid can't. From the Oct. 28 briefing cosponsored by the Centene Corporation. (10 min.)
Ian McCaslin, director of Missouri's Medicaid program, describes how his state is using managed care to improve quality and access to care for Medicaid beneficiaries. From the Oct. 28 briefing cosponsored by the Centene Corporation. (10 min.)
Matt Salo, executive director of the National Association of Medicaid Directors, describes how states are saving Medicaid dollars and improving health outcomes through managed care. From the Oct. 28 briefing cosponsored by the Centene Corporation. (10 min.)
Toolkit on Connection Between Health and Housing
A new Alliance toolkit, “The Connection between Health and Housing: The Evidence and Policy Landscape,” provides a detailed look into federal, state and local initiatives, as well as cost implications for health and housing programs.
Attempts to tie health and housing policy are gaining momentum, amid evidence that housing, a social determinant of health, is an important factor in the health status of various populations. More than 610,000 people experience homelessness in the U.S., and over 250,000 individuals within that population have a severe mental illness or a chronic substance use disorder, according to the Department of Housing and Urban Development.
Toolkit on Biosimilars
The Alliance for Health Reform has released a new toolkit, “Biosimilars: Unpacking Complex Issues.”
The Affordable Care Act created an expedited licensure pathway for biosimilars, and, in March 2015, the U.S. approved the first biosimilar, leaving policy makers, regulators, providers and stakeholders to grapple with regulatory and financial questions.
Biosimilars are similar – but not identical – to biologic drugs, and cost less. Unlike traditional pharmaceuticals, biologic drugs are derived from living organisms and tissues, making them more complex and expensive to produce.