AHIP Issue Brief Focuses on Role of Medicaid Health Plans
A new AHIP Issue Brief provides background information about the Medicaid program and explains how health plans work with the states to deliver care for Medicaid beneficiaries.
Our issue brief provides an overview of the federal-state Medicaid partnership, who is covered by Medicaid and the benefits they receive, the role of Medicaid health plans, research findings on the value offered by Medicaid health plans, and the key issues health plans face under the Medicaid “mega reg” that CMS is expected to finalize at some point this spring.
The brief also highlights key areas where Medicaid health plans are demonstrating strong leadership:
- By offering integrated health care delivery systems, Medicaid health plans promote access to coordinated, quality care and prevent overutilization of services that are both unnecessarily costly and potentially harmful for their enrollees, including dual eligibles.
- By conducting outreach and health education efforts that encourage Medicaid beneficiaries to receive needed preventive care, Medicaid health plans help to reduce unnecessary hospital admissions.
- By helping to manage chronic conditions through patient-centric disease management programs, Medicaid health plans are improving health outcomes while also reducing the costs of providing health care to beneficiaries with complex health care needs.
- By facilitating access to non-medical supportive services, Medicaid health plans enhance the effectiveness of health care service delivery and enable beneficiaries to live in the community.
- By being held accountable through extensive state and federal regulations and detailed contractual agreements for ensuring access to services, and reporting on beneficiary satisfaction and quality measures, Medicaid health plans are improving access to care and the quality of care provided to the vulnerable beneficiaries they serve.
Our new Medicaid issue brief is discussed in this AHIP Coverage blog post.