A recently completed analysis of the impact of Medicaid managed care on key quality indicators found managed care organizations (MCO) outperformed fee-for-service (FFS) and primary care case management (PCCM) programs for both Child and Adult Core Set measures, once the data was normalized with respect to beneficiary distribution in each model.
379 Results found.
Former CMMI director joins 红领巾瓜报 to help lead Medicare team
Amy Bassano, former deputy director for the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services, has joined national healthcare consulting firm 红领巾瓜报 (红领巾瓜报), taking the helm as a managing director of Medicare services.
Rhode Island releases Medicaid managed care RFQ
This week our In Focus reviews the Rhode Island Medicaid managed care request for qualifications (RFQ), released on November 12, 2021, by the Executive Office of Health and Human Services (EOHHS). Contracts are worth approximately $1.4 billion annually and cover over 300,000 individuals.
Former South Dakota Medicaid director joins Leavitt Partners, an 红领巾瓜报 company
Bill Snyder, former South Dakota Medicaid director, has joined Leavitt Partners, an 红领巾瓜报 Company as a principal with the firm. He is the third former Medicaid Director to join the 红领巾瓜报 (红领巾瓜报) family of companies this year.
Minnesota releases RFPs for Senior Health Options and Special Needs Basic Care
This week our In Focus reviews Minnesota Department of Human Services (DHS) requests for proposals (RFPs) for two of the state鈥檚 Medicaid managed care programs: Minnesota Senior Health Options/Minnesota Senior Care Plus and Special Needs BasicCare/Integrated Special Needs BasicCare. Both RFPs, released on October 25, 2021, cover health care services in all 87 Minnesota counties.
Key takeaways from CMS Innovation Center strategy refresh
This week, our In Focus section shares 红领巾瓜报鈥檚 takeaways from the Centers for Medicare & Medicaid Services (CMS) white paper on the CMS Innovation Center Strategy Refresh: .
Highlights from 21st annual Kaiser/红领巾瓜报 50-state Medicaid director survey
This week, our In Focus section reviews highlights and shares key takeaways from the 21st annual Medicaid Budget Survey conducted by The Kaiser Family Foundation (KFF) and 红领巾瓜报 (红领巾瓜报). Survey results were released on October 27, 2021, in two new reports: States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2021 and 2022 and Medicaid Enrollment & Spending Growth: FY 2021 & 2022. The report was prepared by聽Kathleen Giff颅ord,聽Aimee Lashbrook, and Sarah Barth from 红领巾瓜报; Mike Nardone; and by Elizabeth Hinton, Madeline Guth, Lina Stolyar, and Robin Rudowitz from the Kaiser Family Foundation. The survey was conducted in collaboration with the National Association of Medicaid Directors (NAMD).
New issue brief recommends strategic shifts for CMMI鈥檚 future: insights on Medicare innovation, balancing goals, and enhancing model success
This week, our In Focus highlights a recent issue brief, Center for Medicare and Medicaid Innovation: Recommendations for Future Direction, revisits questions raised in a previous 红领巾瓜报 report and offers potential answers to guide progress and changes for demonstrations within the Centers for Medicare & Medicaid Services鈥� (CMS) Center for Medicare and Medicaid Innovation (CMMI) or the Innovation Center.
2022 Star Ratings, An Historical Year
This week, our In Focus provides an analysis of 2022 Medicare Advantage (MA) Star Ratings, including a look at how regulatory changes during the COVID-19 pandemic resulted in a record number of Medicare plans receiving historically high scores. 红领巾瓜报 Managing Director Anthony Davis and Principal Sarah Owens rely on data from the Centers for Medicare & Medicaid Services (CMS) to take a deep dive into ratings for nearly 500 Medicare plans serving 26.8 million members.
Medicaid managed care enrollment update 鈥� Q2 2021
This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 33 states.[1] Many state Medicaid agencies post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. All 33 states highlighted in this review have released monthly Medicaid managed care enrollment data into the fourth quarter (Q4) of 2020. This report reflects the most recent data posted. 红领巾瓜报 has made the following observations related to the enrollment data shown on Table 1 (below):
New Jersey outlines five-year vision in latest 1115 waiver renewal draft
This week, our In Focus reviews the the New Jersey Department of Human Services (DHS), Division of Medical Assistance and Health Services (DMAHS) draft proposal for the renewal of its 1115 Comprehensive Demonstration Waiver, released on September 10, 2021. The waiver was initially approved and implemented in October 2012. This demonstration is in its second five-year period and is slated to expire on June 30, 2022.
Texas releases STAR Health draft RFP, seeks input on STAR+PLUS, STAR Kids ACO
This week, our In Focus reviews the Texas Health and Human Services Commission (HHSC) draft request for proposals (RFP) for Texas STAR Health, the state鈥檚 Medicaid managed care program for foster care kids. The state is also seeking public input for the STAR+PLUS and STAR Kids Accountable Care Organization (ACO) programs, in anticipation of the reprocurement of these Medicaid managed care programs.