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

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<strong>Medicaid</strong> recipients. <strong>Medicaid</strong> managed care is very different from
commercial managed care. To be successful, managed care organizations
need to recognize these differences, and States need to help
them learn how to adapt their product lines to serve <strong>Medicaid</strong> recipients.
<strong>Medicaid</strong> offers more benefits than most commercial
health plans ever dreamed of. It is subject to greater public oversight,
has more Federal requirements than commercial insurance.
<strong>Medicaid</strong> recipients are poor, generally less educated and have
chronic health problems and access problems that the commercial
population may not have.
We believe that our <strong>Medicaid</strong> contract requirements, with their
emphasis on special health care needs of low-income people have
resulted in significant changes in Wisconsin in commercial managed
care.
Developing. the kind of broad infrastructure I have described
takes time and money. Many State <strong>Medicaid</strong> programs, including
Wisconsin's, have invested both for some time now. <strong>Medicaid</strong> has
become the national laboratory to refine and improve managed
care. I am confident that States can use their resources and experience
to improve health care for persons with special health care
needs while continuing to slow the rate of expenditure growth.
[The prepared statement of Ms. Bartels follows:]