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Medicaid Managed Care Cms Should Improve Oversight Of Access And Quality In States Long Term Services And Supports Programs
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Author :United States. Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781977516008 Total Pages :44 pages Book Rating :4.5/5 (16 download)
Book Synopsis Medicaid Managed Care by : United States. Government Accountability Office
Download or read book Medicaid Managed Care written by United States. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-09-21 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: Twenty-two states use MLTSS programs to provide care for Medicaid beneficiaries who need long-term support. Using managed care to deliver long-term services and supports can be a strategy for states to expand home- and community-based care, which many beneficiaries prefer, and to lower costs. However, given the potential vulnerability and needs of beneficiaries in these programs, oversight is crucial to ensure their access to quality care. GAO was asked to review states' implementation and CMS's oversight of MLTSS programs. In this report, GAO (1) described how selected states monitored MLTSS access and quality, and (2) examined the extent to which CMS oversees MLTSS access and quality in selected states. GAO reviewed federal regulations, guidance, and internal control standards. For six states selected for variation in location, program size and duration, and other factors, GAO reviewed reporting requirements, reports to CMS, and other documents. GAO also reviewed data from these states on beneficiary appeals and grievances from 2013 through 2015-the most recent data available-and interviewed state and CMS officials.
Book Synopsis Medicaid Managed Care, CMS Should Improve Oversight of Access and Quality in States' Long-term Services and Supports Programs by : United States. Government Accountability Office
Download or read book Medicaid Managed Care, CMS Should Improve Oversight of Access and Quality in States' Long-term Services and Supports Programs written by United States. Government Accountability Office and published by . This book was released on 2017 with total page 39 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Longterm care federal oversight of growing Medicaid home and communitybased waivers should be strengthened : report to Congressional requesters by :
Download or read book Longterm care federal oversight of growing Medicaid home and communitybased waivers should be strengthened : report to Congressional requesters written by and published by DIANE Publishing. This book was released on with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781982014049 Total Pages :44 pages Book Rating :4.0/5 (14 download)
Book Synopsis Managed Care by : United States Government Accountability Office
Download or read book Managed Care written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-12-25 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: MANAGED CARE: CMS Should Improve Oversight of Access and Quality in States' Long-Term Services and Supports Programs
Author :United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations Publisher : ISBN 13 : Total Pages :160 pages Book Rating :4.0/5 (18 download)
Book Synopsis Medicaid Managed Care by : United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations
Download or read book Medicaid Managed Care written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations and published by . This book was released on 1993 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid Managed Care by : United States. General Accounting Office
Download or read book Medicaid Managed Care written by United States. General Accounting Office and published by . This book was released on 1995 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781977508195 Total Pages :42 pages Book Rating :4.5/5 (81 download)
Book Synopsis Medicaid Managed Care by : United States. Government Accountability Office
Download or read book Medicaid Managed Care written by United States. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-09-22 with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt: The provision of long-term services and supports in Medicaid is a significant challenge, because of the vulnerability and service needs of beneficiaries, as well as the high cost of care. An increasing number of states have MLTSS programs, which can be used to expand community-based care and lower costs. However, whether these programs are an effective strategy depends, in part, on the design of the payment structures. GAO was asked to review states' MLTSS payment structures and CMS's oversight. This report examines (1) how selected states structured their financial incentives, and (2) CMS policies and procedures for overseeing states' payment structures. GAO reviewed relevant federal regulations, guidance, and internal control standards. For six states selected for variation in location and experience (AZ, DE, FL, KS, MN, and TX), GAO reviewed the contracts and rate certifications most recently approved by CMS, the terms and conditions set by CMS for the programs, and other payment documentation. GAO also interviewed CMS officials and Medicaid officials from the selected states.
Book Synopsis Medicaid Managed Care by : United States. Government Accountability Office
Download or read book Medicaid Managed Care written by United States. Government Accountability Office and published by . This book was released on 2010 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid managed care rates are required to be actuarially sound. A state is required to submit its rate-setting methodology, including a description of the data used, to the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) for approval. The Children's Health Insurance Program Reauthorization Act of 2009 required GAO to examine the extent to which states' rates are actuarially sound. GAO assessed CMS oversight of states' compliance with the actuarial soundness requirements and efforts to ensure the quality of data used to set rates. GAO reviewed documents, including rate-setting review files, from 6 of CMS's 10 regional offices. The selected offices oversaw 26 of the 34 states with comprehensive managed care programs; the states' programs varied in size and accounted for over 85 percent of managed care enrollment. GAO interviewed CMS officials and Medicaid officials from 11 states that were chosen based in part on variation in program size and geography. GAO recommends that CMS implement a mechanism to track state compliance with the requirements, clarify guidance on rate-setting reviews, and make use of information on data quality in overseeing states' rate setting.
Book Synopsis Remaking Medicaid by : Stephen Davidson
Download or read book Remaking Medicaid written by Stephen Davidson and published by Jossey-Bass. This book was released on 1998-06-26 with total page 424 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written for health care executives, physicians, nurses, policymakers, health services researchers, and scholars, Remaking Medicaid offers a vision of the future to which conscientious policymakers and provider organizations, working together, can aspire.
Book Synopsis Medicaid Managed Care by : United States. General Accounting Office
Download or read book Medicaid Managed Care written by United States. General Accounting Office and published by . This book was released on 1997 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare and Medicaid Participating Facilities by : John E. Dicken
Download or read book Medicare and Medicaid Participating Facilities written by John E. Dicken and published by DIANE Publishing. This book was released on 2010-02 with total page 90 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans receive care from tens of thousands of health care facilities participating in Medicare and Medicaid. To ensure the quality of care, the Centers for Medicare and Medicaid Services (CMS) contracts with states to conduct periodic surveys and complaint investigations. The auditor evaluated survey funding, state workloads, and fed. oversight of states' use of funds since FY 2000 to determine if fed. funding had kept pace with the changing workload. He analyzed: (1) fed. funding trends from FY 2000 through 2007 and CMS's methodology for determining states' allocations and spending; (2) CMS data on the number of participating facilities and completed state surveys; and (3) CMS oversight of state spending. Includes recommendations. Illus.
Book Synopsis Medicaid Managed Care by : United States. General Accounting Office
Download or read book Medicaid Managed Care written by United States. General Accounting Office and published by . This book was released on 2000 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis A Health Care Quality Improvement System for Medicaid Managed Care by :
Download or read book A Health Care Quality Improvement System for Medicaid Managed Care written by and published by . This book was released on 1993 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid managed care : states' safeguards for children with special needs vary significantly : report to congressional requesters by :
Download or read book Medicaid managed care : states' safeguards for children with special needs vary significantly : report to congressional requesters written by and published by DIANE Publishing. This book was released on with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid Managed Care by : U.s. Government Accountability Office
Download or read book Medicaid Managed Care written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-08-11 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid managed care rates are required to be actuarially sound. A state is required to submit its rate-setting methodology, including a description of the data used, to the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) for approval. The Childrens Health Insurance Program Reauthorization Act of 2009 required GAO to examine the extent to which states rates are actuarially sound. GAO assessed CMS oversight of states compliance with the actuarial soundness requirements and efforts to ensure the quality of data used to set rates. GAO reviewed documents, including rate-setting review files, from 6 of CMSs 10 regional offices. The selected offices oversaw 26 of the 34 states with comprehensive managed care programs; the states programs varied in size and accounted for over 85 percent of managed care enrollment. GAO interviewed CMS officials and Medicaid officials from 11 states that were chosen based in part on variation in program size and geography.
Book Synopsis Medicaid Eligibility Quality Control by : United States. Social and Rehabilitation Service
Download or read book Medicaid Eligibility Quality Control written by United States. Social and Rehabilitation Service and published by . This book was released on 1975 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare's Quality Improvement Organization Program by : Institute of Medicine
Download or read book Medicare's Quality Improvement Organization Program written by Institute of Medicine and published by National Academies Press. This book was released on 2006-09-17 with total page 543 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare's Quality Improvement Organization Program is the second book in the new Pathways to Quality Health Care series. Focusing on performance improvement, it considers the history, role, and effectiveness of the Quality Improvement Organization (QIO) program and its potential to promote quality improvement within a changing health care delivery environment that includes standardized performance measures and new data collection and reporting requirements. This book carefully examines the QIOs that serve every state as well as the national program that guides and supports them. In addition, it highlights the important roles that a national program with private organizations in each state can play in promoting higher quality care. Medicare's Quality Improvement Organization Program looks closely at the technical assistance role of the QIO program and the need to encourage and support providers to improve their performance. By providing an in-depth assessment of the federal experience with quality improvement and recommendations for program improvement, this book helps point the way for those who strive to create higher quality and better value in health care. Intended for multiple audiences, Medicare's Quality Improvement Organization Program is essential reading for members of Congress, the federal executive branch, the QIOs, health care providers and clinicians, and stakeholder groups.
