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
502 Plan and Provider Issues ........................................... IV-86 Plan and Provider Coordination and Training ....... ............... IV-86 Community-Based Providers and Financing Issues ...... ........... IV-87 Lessons ...................................................... IV-88 Oversight/Monitoring Quality .......................................... IV-89 Determining Goals ........................................... IV-89 Measuring Success ........................................... IV-89 Using the Data . ........................................... IV-92 Lessons ....................................................... IV-94 Consumer Involvement ........................................... IV-95 Lessons ...................................................... IV-97 Administrative Issues . ........................................... IV-97 Rate-Setting and Risk Sharing . ................................... IV-98 Data Systems ..................... ...................... IV-98 Contracting .................. ......................... IV-99 Lessons ...................................................... IV-100 Conclusion ...................................................... IV-100 The National Academy for State Health Policy + 0 8/97
503 Chapter One Program Design Issues Paul Saucier Muskie School of Public Service University of Southern Maine August 1997 !for STATE HEALTH POLICY
- Page 454 and 455: 452 Apeadls mn Stadad Seee - Defind
- Page 456 and 457: 454 Appedi. M St.d.ed Se&ee s Dneoe
- Page 458 and 459: Chore 456 Am..& IV LAO n.Gd .Mt. ,
- Page 460 and 461: Occupational Therapy and Assessment
- Page 462 and 463: Psychological Services Provider Typ
- Page 464 and 465: 462 AWppdi IV U-e, Cotfi-, E d Othe
- Page 466 and 467: Licensure/Registration Other Standa
- Page 468 and 469: 466 United States General Accountin
- Page 470 and 471: Results in Brief B-276078 468 care
- Page 472 and 473: B-270078 470 Medi-Cal was implement
- Page 474 and 475: _.27_7 Tab 1: Mad-C Eiglbli and Enr
- Page 476 and 477: ~~- - o~~BZ760?S 474 I J I the enro
- Page 478 and 479: B.276078 476 delaying the contracti
- Page 480 and 481: State's Education Process Has Not R
- Page 482 and 483: B.276078 480 and thereby supplement
- Page 484 and 485: Weaknesses in State Management of t
- Page 486 and 487: B-276078 484 standards can provide
- Page 488 and 489: Insufficient Communication and Invo
- Page 490 and 491: Some Safety-Net Providers Are Encou
- Page 492 and 493: Conclusions B-276D78 490 Safety-net
- Page 494 and 495: B-270078 492 current enrollment bro
- Page 496 and 497: Contents Letter 494 Appendix 30 Sco
- Page 498 and 499: (1115) oPP. -.M.taoy 496 oversight
- Page 500 and 501: 498 ACKNOWLEDGEMENTS This Volume of
- Page 502 and 503: 500 Is Lock-in to a Managed
- Page 506 and 507: 504 Chapter 1 Program Design Issues
- Page 508 and 509: 506 Other studies attest to improve
- Page 510 and 511: 508 Will the Program Be Voluntary o
- Page 512 and 513: 510 additional option for people wi
- Page 514 and 515: 512 contractor collect spenddown pa
- Page 516 and 517: 514 Option A is still quite rare. P
- Page 518 and 519: 516 experience with special populat
- Page 520 and 521: 518 particularly on a full risk bas
- Page 522 and 523: 520 Dual eligibility raises a disti
- Page 524 and 525: 522 special populations, and states
- Page 526 and 527: 524 Chapter 2 Care
- Page 528 and 529: 526 settings. Finally, plans that s
- Page 530 and 531: 5281 needs. For example, women who
- Page 532 and 533: 530 Oregon's rules require that pla
- Page 534 and 535: 532 beneficiaries on July 1, 1997.
- Page 536 and 537: 534 facility's delivery, dosage, an
- Page 538 and 539: 536 * Strategies for measuring netw
- Page 540 and 541: 538. arrangements with traditional
- Page 542 and 543: 540 community based or well elders.
- Page 544 and 545: 542 Finally, coordination for vulne
- Page 546 and 547: 544 Care Coordinat
- Page 548 and 549: 546 home health agency developed a
- Page 550 and 551: 548 develop a case management syste
- Page 552 and 553: 550 Coordinating services is compli
502<br />
Plan and Provider Issues ...........................................<br />
IV-86<br />
Plan and Provider Coordinati<strong>on</strong> and Training ....... ............... IV-86<br />
Community-Based Providers and Financing Issues ...... ........... IV-87<br />
Less<strong>on</strong>s ......................................................<br />
IV-88<br />
Oversight/M<strong>on</strong>itoring Quality .......................................... IV-89<br />
Determining Goals ........................................... IV-89<br />
Measuring Success ...........................................<br />
IV-89<br />
Using the Data . ........................................... IV-92<br />
Less<strong>on</strong>s .......................................................<br />
IV-94<br />
C<strong>on</strong>sumer Involvement ........................................... IV-95<br />
Less<strong>on</strong>s ......................................................<br />
IV-97<br />
Administrative Issues . ........................................... IV-97<br />
Rate-Setting and Risk Sharing . ................................... IV-98<br />
Data Systems ..................... ...................... IV-98<br />
C<strong>on</strong>tracting .................. ......................... IV-99<br />
Less<strong>on</strong>s ......................................................<br />
IV-100<br />
C<strong>on</strong>clusi<strong>on</strong> ...................................................... IV-100<br />
The Nati<strong>on</strong>al Academy for State Health Policy + 0 8/97