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

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plan for that matter, can measure quality for a population that is
so statistically small.
Finally, on Tuesday, July 22, we will have panelists discussing
the problems faced by States that want to contract to purchase
managed care plans for their <strong>Medicaid</strong> beneficiaries with special
needs. Each of these forums is at 9:30 in this room.
Our plan is to make a formal record of these forums that will be
available to you from the Aging <strong>Committee</strong> when we are done. I
want to thank LaVita Westbrook for organizing all these and keeping
us on track. She has done a great job.
Now I'll introduce our panelists. Bill Scanlon is director of the
Health Financing and Systems Issue Area at the U.S. General Accounting
Office. He has been engaged in health services research
since 1975. Before joining GAO in 1993, Dr. Scanlon was co-director
of the Center for Health Policy Studies and an associate professor
in the Department of Family Medicine at Georgetown University.
His research is focused in particular on the Medicare and
<strong>Medicaid</strong> programs, especially provider payment policies, and the
provision and financing of long-term care services, which is especially
important for this population we are talking about.
Barbara Smith is a senior research staff scientist at the Center
for Health Policy Research at the George Washington University.
She is a lawyer specializing in health law and health policy analysis.
Her work focuses on health care financing and the Federal
budgetary implications of health care financing reform and the restructuring
of the health care delivery system. Some of you may be
familiar with the Center for Health Policy Research's recent study
on <strong>Medicaid</strong> managed care contracts by the States. Barbara was
very much involved in that.
Patricia Riley is Vice President of Government Programs, Policy
and Planning for Medica Health Plans at Allina Health System
based in Minneapolis. Ms. Riley has over 20 years of professional
experience in health and human services, most of which is concentrated
in Government health programs, including Medicare and
<strong>Medicaid</strong>. She is one of the developers of the Prepaid Medical Assistance
Programs, or PMAP, in Minnesota. I am glad she could
come and join us today.
I believe we'll just go in the order of Bill, Barbara, and Patsy,
and I will go ahead and turn it over to Bill.
STATEMENT OF WILLIAM J. SCANLON, DIRECTOR OF HEALTH
FINANCING AND SYSTEMS ISSUE AREA, U.S. GENERAL AC-
COUNTING OFFICE, WASHINGTON, DC
Mr. SCANLON. Thanks very much, Susan. I am very happy to be
here today as the Aging <strong>Committee</strong> considers the important issue
of managed care for people with disabilities, in particular people
with very significant service needs.
I would like to start by talking some about what was presented
at the panel 2 weeks ago, because I thought that their presentations
provided a number of themes which are important to keep
in mind as we consider the issues of managed care for people with
special needs.
The panel 2 weeks ago demonstrated very vividly the broad
range of service needs for people with severe, chronic and disabling