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

Conclusion
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Over the past decade, managed care arrangements have become a viable alternative to states seeking
innovative strategies to provide medical assistance beneficiaries with quality health care in a costeffective
manner. Designing and implementing a <strong>Medicaid</strong> managed care program involves a plethora
of issues which the states, providers and citizens must address. Many of the basic components for the
development of a sound <strong>Medicaid</strong> managed care program remains the same irrespective of whether
the public <strong>Medicaid</strong> assistance plan is a federal-state matching program or a block grant Among the
range of significant concems, ensuring the financial solvency of <strong>Medicaid</strong> managed care plans is
prominent. Ensuring financial solvency involves not only setting meaningful capital and reserve
requirements but establishing standards and monitoring adequately the business practices of plans.
Regulators in state insurance departments, <strong>Medicaid</strong> agencies, or other applicable agencies may have
areas of expertise the contribution of which will facilitate state efforts to design an effective program.
By working with providers and citizens within the state, states regulators will maximize their ability to
balance the goals of protecting consumers, disseminating information to all concerned parties about
the new managed care system, and facilitating the ability of managed care plans to perform their
contractual obligations effectively.
ONAIC 1996 13
44-098 97-11