Medicaid Managed Care - U.S. Senate Special Committee on Aging

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HealthChoice Fact Sheet
On October 30, 1996 the U.S. Department of Health and Human
Services (HHS), granted Maryland's request for authority under
Section 1115 of the Social Security Act to implement a statewide
health care reform research and demonstration project. The
Maryland <strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong> Program, known as HealthChoice,
reflects the direct participation of 125 representatives from
health care provider and consumer groups, 1750 private citizens
who participated in seventeen public hearings across the state
and several groups of <strong>Medicaid</strong> recipients who were involved in
focus groups and consumer forums.
On November 8_-1995, the Maryland General Assembly Joint
<strong>Committee</strong> on Administrative, Executive and Legislative Review
approved emergency regulations to begin the actual implementation
of HealthChoice. The Maryland Department of Health and Mental
Hygiene (DHMH) will begin to enroll recipients into HealthChoice
<strong>Managed</strong> <strong>Care</strong> Organizations (MCOs) in June 1997. This will be the
beginning of a five-month phase-in enrollment process for almost
300,000 <strong>Medicaid</strong> recipients in Maryland.
Guiding Principles For HealthChoice
The HealthChoice program is based on several underlying
principles which are designed to make it an unique Maryland
program. These principles are:
* Patient-focused -
designed to meet the needs of people and to provide a
single medical home for all members is "consumer
friendly" and emphasizes consumer choice and minimal
disruption while changing from the current program to
the MCO program
* Builds on Maryland's health care strengths -
a number of <strong>Medicaid</strong> recipients already participate in
a Health Maintenance Organization (HMO) or have a
primary care provider
* Provides a comprehensive, prevention and primary careoriented
system of health care -
<strong>Managed</strong> <strong>Care</strong> Organizations (MCOs) will stress health
promotion/disease prevention and provide access to
primary and speciality health care services MCOs will
be required to meet performance standards and quality
of care standards to meet the needs of all <strong>Medicaid</strong>
recipients including special high-risk populations
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