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

527
Chart B
National Academy for State Health Policy
<strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong>
Strategies for Assuring Access
9z'16s Risk-Based Contracting
90% =2 9 3A; eD& 0 SSI nElderly
60% 605. 6a%
70% | 0.26 2
_64% 013
060% 55%
0.19
40% 36%37 36
0.12 0. 09
30% ~. 26%
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10%
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G0B0r* Pelnry Wadodbgnert Bringingb In r <strong>Special</strong>ty N.oi.eal
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Contractors are Evaluated Based On
of strategies such as: using geographic access mapping of providers and
beneficiaries; examining the plans primary and specialty care networks; and
examining the plan's ability to make new providers available to enrolled
beneficiaries. However, traditional measures such as the number of providers in
relation to the enrolled population and time/distance measures, may not be
appropriate to measure access for vulnerable populations. It is important to know
whether the plan's providers are willing to care for people with disabilities and
whether they have experience doing so. Consumers themselves may prefer to
travel significant distances to see a provider that is experienced with the person's
condition rather than a provider that is nearby but lacks this expertise. (For more
discussion of all of the strategies identified in the charts please refer to the access
chapter in Volume II of this Guide.)
Access to Primary <strong>Care</strong> Providers With Knowledge/Experience Caring for
Members of <strong>Special</strong> Populations
Members of special populations sometimes need primary care providers who
understand the connections between chronic conditions and primary health care
The National Academy for State Health Policy e C 8/97 IV-24
42%