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

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Addressing Continuity . .......................................... IV-53
State Strategies for Transferring Information About Health
Services Upon Enrollment ........ ................... IV-54
Who Enrolls Beneficiaries ............... ......................... IV-54
Oregon Model . ............................................. IV-55
Other State Strategies for Enrollment ....... ................. IV-57
Dual Eligibility and Enrollment ........... ........................ IV-57
State Experience Enrolling Dual Eligibles ...... ............... IV-59
Tracking Enrollment of Dually Eligible Beneficiaries ... IV-60
Disenrollment . .................................................. IV-60
Highlights ....................................................... IV-61
Financing <strong>Managed</strong> <strong>Care</strong> for Vulnerable Populations ...... ............... IV-62
Solvency Requirements ............. ............................. IV-62
Capitation Payments ................ ............................. IV-63
Sharing Risk . .................................................... IV-65
Highlights ....................................................... IV-67
Quality Improvement . .................................................. IV-67
Internal Quality Program Standards ........ ....................... IV-69
External Reviews . ................................................ IV-70
State Experience with EQRO Reviews ...... .................. IV-70
Reviews Performed by State Staff ....... ..................... IV-71
Oregon .............. ............................... IV-71
Arizona .............. .............................. IV-72
Quality Assurance for <strong>Special</strong> Populations and Dual Eligibility ....... IV-73
Medicare Quality Standards ......... ........................ IV-74
Potential for Coordination Between <strong>Medicaid</strong> and Medicare ... IV-75
Highlights . ..................................................... IV-76
Summary ............................................................. IV-77
Chapter 3
<strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong> and Mental Health
Introduction .......................................................... IV-79
Integrating Physical and Mental Health <strong>Care</strong>: To Carve Out or Not to Carve
Out? ........................................................... IV-79
System Design . .................................................. IV-79
Goals of <strong>Managed</strong> Mental Health <strong>Care</strong> ........ ..................... IV-82
Coordinating Medical and Non-Medical <strong>Care</strong> ...... ................ IV-83
Engaging Stakeholders ............. .............................. IV-84
Lessons ......................................................... IV-85
The National Academy for State Health Policy* @ 8/97