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

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

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Primary Program AFDC/H8 Provlqar Characlerlsaics ong>Medicaidong> Pro rdm HMO (PPP) ooaInruot EnmUe. .oM mbW y-da-Ce ,3... 3.Volpatlw sm4or00 03rr3gh PCP. Earolmaui htdO ponldan. oblhehard ra(n PCP before soeldng Program lor Independent All Inclusive ong>Careong> ong>Careong> tor the WI Children (I-ong>Careong>) Elderly Partnership Coma FOral I (PACE) Program (CCF) En E"o". .a. lookeCd. E-,soimy.. . lot u. 0al nasd.saiew , Inblo PACE aoowCy their own phy8ooan. d a0 ldagaroy .43tho310 day 0t p0wsb3 adxs3v0oy. They usa 8or cont33 l aSl td8tr4n8. e erokMf. lhoy Also alhnd dUU day eanfy cv WrapAround Milwaukee (WAM) 8.oi. muS High Co&) Case Moanagement (HCCM) 03 33 b pe3rclpat In P0o(rWr. sefticas trom a mur38l d302834llaln*r cu8e, r co,,t3adr d speolist hrr0uo3h I Cutsa p 3ov0for SUtall :owo.,aa sorve t -- l 000ItdO covIr U r Traditio nl t83ld0 "oMcas .1oh wmould FF9 Covera4g. po3si nshyodl. Tr1a,3nsi Mtdol d FF9 coaowae. Alo mrrdWic s eo . _ Tiadlona 2l3.t0d.ld 7,odl.onel M. odd All n 83y td33H 3nd 08 FFS covcoagp. Us. FFS covrga pbPe AOOA s0or0a or CCF T300380nS Mtdewcald FFS covwaga. be 04c 33t3d01083 00008. 8 Mrka3r1and s88l8c3s43h3h LV8 Including 303183083 Modiald FPS. o803i,82a8l3 tonat Medicab founds 3o ,30300 cover8d bSy Iadl3ondlY0 0 D30i38d ao3iles 8and wraplolnrod .odal Mr3dk3d. such as 00dr84 Modad. .dudo 4 Services vre__nna woovams. All /.&rVv3 a0rk3ad Al l840308s w2ded by M3o3obr d P30mgn by 003e3l303d pFrog- 1030 m3y 0e003not0 toh0080h d00338 033tr0. r-ve308. SONIC&$. H30d3 hn13ml a aow.vd b-a§oL Social . f3.0(l08.!_ | Ibao1 oIxol *.00 0-0.0d bernal U Phyroal 23odo8 S3me ae CCF .34 9 . 0ov0 d 30lor. Al 130 .. ex00ud0 d by t0.d43a8 phl840. 0"0I 0388tu0 ApprwL 80b AFOC and Hearty Smrlaelpdbbx .sibe 0mrol0d0 bIHMrsoby 6.e00s n.I-. nd 2,3nd 00 ls88 in 170 Primary plov del0 FbmDuy 3007 a d8 M-8h 10307 3308ro8l0 3n MIwauxr e0.0n ol C.amb3,2 1080. Edlpatadl. s*ogs Ttwoul I., 0l33d3ry 17300 8 d0in 319 an CCF od33ol w03h3tJ0003a3 * r0o~bnd r. peol83pana. Phy3k0 IMP.Unl hoop3la3 d33ab3al3 "od days iodcdn buotpl C0n03308pandVV3 3354000D3O 00d833 E,3-a1d May 3v97. S3avlngsol3$Slemion fo- n0n.0pahn o- rGaa.o00o FY bgon Jun I 300. S5 Itn Cm* Cowiy' 100 prootpant. eJ of 3.3 b.oa p.,.r l-Pl pw rnonth. E.1ld a-33 .,0g. .Wnof 1. 6%. tr04s for expansion HMOs3 I FY 86. Slal033d0 exparpwn tF1dra. 300308 Epttal on o0 SSI Dec0 0rlogo. 1 _C8nter0 l 51 50.00CY '894 _ wiL8 be caompla ad In expb0 0on12817.) 031man3e3d "re30o 30330o Indrpoend3nt UviWo Mry 38317. 83dd3lonal 0o0un33b, l3t We0tltm K0no0hu rnd Roalmo 3.oon0dn (CILWYV) 18 plonnel ol 0n 8dUon0l sit3 los J0Y01003I208. 30 ald01l3 1 81o0 d 3h physfoal disabiills modOl. h, bano pl9nn7d I. May 1997. orch 20. 1907/BHCF/MC Page 5 of 6

Program AFDC/HS Primary ProvIdar Independenr ong>Careong> Program for All Inclusive ong>Careong> for Ihe WI Chldxen WrapAround Mllwaulee High Coal Case 'hanitclorisilce ong>Medicaidong> HMO Program (PPP) (jiCama) Elderly (PACE) Partnersaip Program Come FIral (CCF) (WAM) Management (HCCM) Ve in monitorsing 440. mot1 rubt1 An tnlrnM ntem CF HIlO. O& niFH tImik Arit A rscites. toc, An WSernl A 7r Force ha A Communily M biamal BHCI quiflay ultalb mkoup st_ ben qry and r is b r =*ad sndor witi wdtthet I been appointedby Pannsetsep tem hao wotrorcp has been *ndglty b lorr M Adhad to rmnal Udttllion rnd HCFA lovwatiets Oe ovelrseing th tr Cmarty Exrculve been appintled to established lo doe. Permrn end "oisu nwi el1hfihdtltotrdesta. pioagarn, ok dat rosesawch tnd to step tssat. helpaesaanlhe aovaaatb t, modaM amot prte alnm Program nWmdcrled oledIna n.1 Muslim) btptmid Iopea and progrnm ionduted by 10F. Cdl me rmconducted O1i0 On Inok and rmonents, enal hre prm-..ao1 the pu, a na- at Ut by 0HOF. PACE repkabon pidoc ad MMl POWWA m nd ate prxagani and maeI 1H,6n Gtntra. eIt. Data e ret" rmkidl. The orrch sarpn-rmdatonfor reoo rnat lt Reasaich InrLtulr tSFIt at met PACE epcand a tMtended to poide necesarmy cwanees. nenerarty ohng. surN, Macld tnd dalr on etulo mnd Marssadnaseie No hlola. Meddale mid hane an rooAse evlutated tl dowilty dota; and pealbrA oatcomue plomgr ahp t CAPACE syetm; and AuIl ptnId, HCFA' ong>Medicaidong> wn, tnieme end Aitarmointn on q ualtly Steb1t1cal ott. ualtt. Ftnal r eaure U-Al nan Infaruloamral SyAten repmr seralmd * b Ienhorporated kilo (MS8), a brd tICFA humfirnse i proudhu contracts rnat kitmlanNtam lo0x routi, ad Intonteiese VI sttll to data eounice. 1 wrd late Madoetd qualily esoomnco system. HSRt t uss I.C.eVe ceauo d rbase mnd uWiatisor Abo. Pgo s'dr Srecihy Adminitrdatton wit priCd date an . .ahbalitn by diabltehy type at WIt atttjteboae Oes1cl reclowfu In MU-Aso C-uny. wch20, 1997/BHCF/MC Pago 6 ol 6

Primary<br />

Program AFDC/H8 Provlqar<br />

Characlerlsaics <str<strong>on</strong>g>Medicaid</str<strong>on</strong>g> Pro rdm<br />

HMO (PPP)<br />

ooaInruot EnmUe. .oM mbW y-da-Ce ,3...<br />

3.Volpatlw sm4or00 03rr3gh PCP. Earolmaui<br />

htdO p<strong>on</strong>ldan. oblhehard ra(n<br />

PCP before soeldng<br />

Program lor<br />

Independent All Inclusive<br />

<str<strong>on</strong>g>Care</str<strong>on</strong>g> <str<strong>on</strong>g>Care</str<strong>on</strong>g> tor the WI Children<br />

(I-<str<strong>on</strong>g>Care</str<strong>on</strong>g>) Elderly Partnership Coma FOral<br />

I (PACE) Program (CCF)<br />

En E"o". .a. lookeCd. E-,soimy.. . lot u.<br />

0al nasd.saiew , Inblo PACE aoowCy their own phy8ooan. d a0 ldagaroy<br />

.43tho310 day 0t p0wsb3 adxs3v0oy. They usa 8or c<strong>on</strong>t33 l aSl td8tr4n8. e<br />

erokMf. lhoy Also alhnd dUU day eanfy cv<br />

WrapAround<br />

Milwaukee<br />

(WAM)<br />

8.oi. muS<br />

High Co&)<br />

Case<br />

Moanagement<br />

(HCCM)<br />

03 33<br />

b pe3rclpat In<br />

P0o(rWr.<br />

sefticas trom a mur38l d302834llaln*r cu8e, r co,,t3adr d<br />

speolist hrr0uo3h I Cutsa p 3ov0for SUtall<br />

:owo.,aa sorve t -- l 000ItdO covIr U r Traditio nl t83ld0<br />

"oMcas .1oh wmould FF9 Covera4g.<br />

po3si nshyodl.<br />

Tr1a,3nsi Mtdol d<br />

FF9 coaowae. Alo<br />

mrrdWic s eo . _<br />

Tiadl<strong>on</strong>a 2l3.t0d.ld 7,odl.<strong>on</strong>el M. odd All n 83y td33H 3nd 08<br />

FFS covcoagp. Us. FFS covrga pbPe AOOA s0or0a<br />

or CCF T300380nS Mtdewcald<br />

FFS covwaga.<br />

be 04c 33t3d01083 00008. 8 Mrka3r1and s88l8c3s43h3h LV8 Including 303183083<br />

Modiald FPS. o803i,82a8l3 t<strong>on</strong>at Medicab founds 3o ,30300 cover8d bSy Iadl3<strong>on</strong>dlY0 0 D30i38d<br />

ao3iles 8and wraplolnrod .odal Mr3dk3d. such as 00dr84 Modad.<br />

.dudo 4 Services<br />

vre__nna woovams.<br />

All /.&rVv3 a0rk3ad Al l840308s w2ded<br />

by M3o3obr d P30mgn by 003e3l303d pFrog-<br />

1030 m3y 0e003not0 toh0080h<br />

d00338 033tr0. r-ve308.<br />

SONIC&$.<br />

H30d3 hn13ml a<br />

aow.vd b-a§oL<br />

Social . f3.0(l08.!_<br />

| Ibao1 oIxol *.00<br />

0-0.0d bernal U<br />

Phyroal 23odo8 S3me ae CCF<br />

.34 9 . 0ov0 d<br />

30lor.<br />

Al 130 .. ex00ud0 d<br />

by t0.d43a8 phl840.<br />

0"0I 0388tu0 ApprwL 80b<br />

AFOC and Hearty<br />

Smrlaelpdbbx .sibe<br />

0mrol0d0 bIHMrsoby<br />

6.e00s n.I-. nd 2,3nd 00 ls88 in<br />

170 Primary plov del0 FbmDuy 3007<br />

a d8 M-8h 10307<br />

3308ro8l0 3n<br />

MIwauxr e0.0n ol<br />

C.amb3,2 1080.<br />

Edlpatadl. s*ogs<br />

Ttwoul I., 0l33d3ry 17300 8 d0in 319 an CCF<br />

od33ol w03h3tJ0003a3 * r0o~bnd r.<br />

peol83pana. Phy3k0 IMP.Unl hoop3la3<br />

d33ab3al3 "od days iodcdn buotpl<br />

C0n03308pandVV3<br />

3354000D3O<br />

00d833 E,3-a1d<br />

May 3v97.<br />

S3avlngsol3$Slemi<strong>on</strong><br />

fo- n0n.0pahn<br />

o- rGaa.o00o FY bg<strong>on</strong> Jun I 300.<br />

S5 Itn Cm* Cowiy'<br />

100 prootpant. eJ of<br />

3.3 b.oa p.,.r l-Pl<br />

pw rn<strong>on</strong>th.<br />

E.1ld a-33 .,0g.<br />

.Wnof 1. 6%.<br />

tr04s for expansi<strong>on</strong><br />

HMOs3 I FY 86.<br />

Slal033d0 exparpwn tF1dra. 300308 Epttal <strong>on</strong> o0 SSI<br />

Dec0 0rlogo. 1<br />

_C8nter0 l<br />

51 50.00CY '894 _<br />

wiL8 be caompla ad In expb0 0<strong>on</strong>12817.) 031man3e3d "re30o 30330o Indrpoend3nt UviWo<br />

Mry 38317. 83dd3l<strong>on</strong>al 0o0un33b, l3t We0tltm<br />

K0no0hu rnd Roalmo 3.o<strong>on</strong>0dn (CILWYV)<br />

18 pl<strong>on</strong>nel ol 0n 8dU<strong>on</strong>0l sit3 los<br />

J0Y01003I208. 30 ald01l3 1 81o0 d 3h<br />

physfoal disabiills<br />

modOl. h, bano<br />

pl9nn7d I. May<br />

1997.<br />

orch 20. 1907/BHCF/MC Page 5 of 6

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