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Medicaid Managed Care Trends In Federal Spending And State Oversight Of Costs And Enrollment
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Author :United States Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781981884841 Total Pages :50 pages Book Rating :4.8/5 (848 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 2017-12-24 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: MEDICAID MANAGED CARE: Trends in Federal Spending and State Oversight of Costs and Enrollment
Book Synopsis Medicaid Managed Care by : Carolyn L. Yocom
Download or read book Medicaid Managed Care written by Carolyn L. Yocom and published by . This book was released on 2015-02-20 with total page 49 pages. Available in PDF, EPUB and Kindle. Book excerpt: The importance of managed care in Medicaid -- under which states contract with managed care organizations (MCOs) to provide a specific set of services -- has increased as states expand eligibility for Medicaid under the Patient Protection and Affordable Care Act (PPACA) and increasingly move populations with complex health needs into managed care. States have flexibility within broad federal parameters to design and implement their Medicaid programs, and therefore play a critical role in overseeing managed care. This report analyzes (1) federal expenditures for Medicaid managed care and the range in selected states' payments made to MCOs; (2) selected states' medical loss ratio (MLR) standards and how they compare with federal standards for other sources of health coverage; and (3) selected states' methods for automatically assigning Medicaid beneficiaries to MCO plans. Tables and figures. This is a print on demand report.
Book Synopsis Medicaid Managed Care, Trends in Federal Spending and State Oversight of Costs and Enrollment by : Government Accountability Office
Download or read book Medicaid Managed Care, Trends in Federal Spending and State Oversight of Costs and Enrollment written by Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-28 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: "analyzed federal data on Medicaid expenditures for comprehensive risk-based managed care. GAO selected eight states because they used managed care for some portion of their Medicaid population and were geographically diverse. For these states, GAO reviewed state payment data and documentation, including contracts with MCOs, and interviewed state officials. GAO also reviewed federal laws to describe MLR minimums in Medicare and the private insurance market. The Department of Health and Human Services had no comments on this report. What GAO Found Federal spending for Medicaid managed care increased significantly from fiscal year 2004 through fiscal year 2014 (from $27 billion to $107 billion), and represented 38 percent of total federal Medicaid spending in fiscal year 2014. Consistent with this national trend, managed care as a proportion of total federal Medicaid spending was higher in seven of eight selected states in fiscal year 2014 compared with fiscal year 2004. Federal Expenditures for Medicaid Managed Care as a Percentage of Federal Medicaid Expenditures, in Eight States, Fiscal Years 2004 and 2014 Total and average per beneficiary payments by states to managed care organizations (MCOs) varied considerably across the eight selected states in state fiscal year 2014. For example, total payments ranged from $1.3 billion in one state to $18.2 billion in another, and average payments per beneficiary ranged from about $2,800 to about $5,200. While not required by federal policy to do so, five of the eight selected states required MCOs to annually meet minimum medical loss ratio (MLR) percentages-standards that ensure a certain proportion of payments are for medical care and, in effect, limit the amount that can be used for administrative cost and profit. These state minimums generally ranged from 83 to 85 percent, similar to the 85 percent minimums established in the Patient Protection and Affordable Care Act (PPACA) for other sources of health coverage. All MCOs in the five states had MLRs in state fiscal year 2014 that were above the state-required minimums. GAO also found that all eight selected states focused on beneficiary factors, such as assigning a beneficiary to the same managed care plan in which a family member is enrolled, when the state selects a plan for the beneficiary in the absence of the beneficiary choosing a plan-referred to as auto assignment. States also considered plan performance, for example, on quality measures and program goals, such as achieving a certain distribution of enrollment across plans. Auto assignments of beneficiaries ranged from 23 to 61 percent of managed care enrollees across the seven selected states that tracked such data. View GAO-16-77. For more information, contact Carolyn L. Yocom at (202) 512-7114 or [email protected]. Letter"
Book Synopsis Medicaid Managed Care, Trends in Federal Spending and State Oversight of Costs and Enrollment : Report to Congressional Requesters by : United States. Government Accountability Office
Download or read book Medicaid Managed Care, Trends in Federal Spending and State Oversight of Costs and Enrollment : Report to Congressional Requesters written by United States. Government Accountability Office and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid Managed Care, Trends in Federal Spending and State Oversight of Costs and Enrollment by : United States. Government Accountability Office
Download or read book Medicaid Managed Care, Trends in Federal Spending and State Oversight of Costs and Enrollment written by United States. Government Accountability Office and published by . This book was released on 2015 with total page 43 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid by : United States. General Accounting Office
Download or read book Medicaid written by United States. General Accounting Office and published by . This book was released on 1993 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :Jason J. Fichtner Publisher :Mercatus Center at George Mason University ISBN 13 :0989219364 Total Pages :208 pages Book Rating :4.9/5 (892 download)
Book Synopsis The Economics of Medicaid by : Jason J. Fichtner
Download or read book The Economics of Medicaid written by Jason J. Fichtner and published by Mercatus Center at George Mason University. This book was released on 2014-03-24 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid, originally considered an afterthought to Medicare, is today the largest health insurance provider in the United States. Under the Affordable Care Act, the Congressional Budget Office projects Medicaid enrollment to increase nearly 30 percent by 2024 and federal spending on the program to double over the next decade. For the states, Medicaid is already the largest single budget item, and its rapid growth threatens to further crowd out other spending priorities. In this collection of essays published by the Mercatus Center at George Mason University, nine experts discuss the escalating costs and consequences of a program that provides second-class health care at first-class costs. The authors begin with an explanation of Medicaid’s complex state-federal funding structure. Next, they examine how the system’s conflicting incentives discourage both cost savings and efficient care. The final chapters address the pros and cons of the most mainstream Medicaid reform proposals and offer alternative solutions. This book offers a timely assessment of how Medicaid works, its most problematic components, and how—or if—its current structure can be adequately reformed to provide quality care for those in need at sustainable costs. Contributors include: Joseph Antos, American Enterprise Institute Charles Blahous, Mercatus Center at George Mason University Darcy Nikol Bryan, MD, practicing physician James C. Capretta, Ethics and Public Policy Center Robert F. Graboyes, Mercatus Center at George Mason University June O’Neill, Baruch College, CUNY Nina Owcharenko, Heritage Foundation Thomas Miller, American Enterprise Institute
Book Synopsis Medicaid, Assessment of Variation Among States in Per-Enrollee Spending by : U.s. Government Accountability Office
Download or read book Medicaid, Assessment of Variation Among States in Per-Enrollee Spending written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-26 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: " Federal Medicaid expenditures totaled about $267 billion in fiscal year 2013. With the expansion of Medicaid under the Patient Protection and Affordable Care Act and rising health care costs, the Congressional Budget Office projects that such expenditures will grow to about $576 billion by fiscal year 2024. GAO was asked to examine variation among states in Medicaid spending and factors that influence such spending, and state approaches to setting rates per enrollee for Medicaid managed care plans. This report examines (1) Medicaid spending per enrollee by state; (2) selected factors that influence Medicaid spending per enrollee, by state; and (3) how states account for factors that influence expected per-enrollee spending when setting rates for Medicaid managed care plans. GAO analyzed Medicaid enrollment and combined federal and state expenditure data provided by CMS for fiscal year 2008, and examined illustrative examples of factors that have been reported to influence health care spending, such as age, disability status, and scope of benefits received. GAO used 2008 data because they allowed a comparable view of spending per enrollee and factors that influence spending per enrollee-as 2008 was the most recent year for which certain data on factors influencing spending were readily available.
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:
Book Synopsis Medicaid Expenditures and Beneficiaries by :
Download or read book Medicaid Expenditures and Beneficiaries written by and published by . This book was released on 1990 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations Publisher : ISBN 13 : Total Pages :152 pages Book Rating :4.3/5 (91 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 152 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicaid written by and published by DIANE Publishing. This book was released on 1993-08 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: Focuses on: states' use of managed care programs; the difficulty states face in implementing certain program components; the effect of the managed care approach on health care access, quality, & cost; & the presence of features that assure the quality of health services & providers' financial stability. Charts, tables & map.
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 Effect of Managed Care on Medicaid Spending by : Victoria Perez
Download or read book Effect of Managed Care on Medicaid Spending written by Victoria Perez and published by . This book was released on 2015 with total page 190 pages. Available in PDF, EPUB and Kindle. Book excerpt: States choose to provide Medicaid coverage via managed care or traditional fee-for-service (FFS). Managed care provided by private insurers poses higher contracting costs and information asymmetry than traditional FFS, but potentially improves efficiency, reduces spending, and improves budget predictability. There is conflicting evidence about managed care savings for the Medicaid population. In this paper, I estimate the effect of Medicaid managed care on spending, coverage generosity, and budget predictability. I use measures of fiscal stress, political sentiment and electoral turnover as instruments for managed care enrollment. I find reductions in Medicaid spending larger than previously found in cross-state studies. These savings are not re-invested in Medicaid, suggesting there are non-financial constraints to Medicaid expansion. I also find that managed care is no more effective at reducing the occurrence of Medicaid deficits than other inter-temporal adjustments, such as physician payment freezes and reductions in eligibility.
Book Synopsis Medicaid Managed Care by : Geneva Barrett
Download or read book Medicaid Managed Care written by Geneva Barrett and published by . This book was released on 2016 with total page 111 pages. Available in PDF, EPUB and Kindle. Book excerpt: The importance of managed care in Medicaid--under which states contract with managed care organizations (MCOs) to provide a specific set of services--has increased as states expand eligibility for Medicaid under the Patient Protection and Affordable Care Act (PPACA) and increasingly move populations with complex health needs into managed care. States have flexibility within broad federal parameters to design and implement their Medicaid programs, and therefore play a critical role in overseeing managed care. This book analyzes federal expenditures for Medicaid managed care and the range in selected states' payments made to MCOs; selected states' medical loss ratio (MLR) standards and how they compare with federal standards for other sources of health coverage; and selected states' methods for automatically assigning Medicaid beneficiaries to MCO plans. Furthermore, this book examines states' and plans' experiences using federal databases to screen providers; and how states and plans share data about ineligible providers.
Download or read book Medicaid written by Carolyn Yocom and published by . This book was released on 2012-11 with total page 49 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medicaid program, a joint federal-state program that finances health insurance coverage for certain categories of low-income individuals, is an important source of health care coverage for about 67 million beneficiaries. As Medicaid enrollment and spending have increased significantly over the past decade, so too has states' use of managed care to provide services to Medicaid beneficiaries, and nearly all states enroll some Medicaid beneficiaries in a form of managed care. Within some general requirements set out by the Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for overseeing the Medicaid program, states have broad flexibility to implement Medicaid managed care programs. As a result, states vary widely in terms of the scope of services they provide and the populations they enroll in managed care. States also vary in their use of managed care for other reasons, such as differences in the availability of certain providers or the concentration of program beneficiaries that live in urban or rural areas. The Patient Protection and Affordable Care Act (PPACA) of 2010 requires that all states expand eligibility for Medicaid to nonelderly individuals whose income does not exceed 133% of the federal poverty level (FPL); this is estimated to result in the enrollment of an additional 7 million individuals in 2014. This report describe states' use of Medicaid managed care, including the type of managed care arrangements they have in place, and their enrollment of populations with complex health care needs. Figures and tables. This is a print on demand report.
Book Synopsis Has the shift to managed care reduced medicaid expenditures? : evidence from state and local-level mandates by : Mark Gregory Duggan
Download or read book Has the shift to managed care reduced medicaid expenditures? : evidence from state and local-level mandates written by Mark Gregory Duggan and published by . This book was released on 2011 with total page 39 pages. Available in PDF, EPUB and Kindle. Book excerpt: From 1991 to 2003, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 58 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from fee-for-service into managed care would lead to an increase or a reduction in Medicaid spending. This paper investigates this effect using a data set on state and local level MMC mandates and detailed data from CMS on state Medicaid expenditures. The findings suggest that shifting Medicaid recipients from fee-for-service into MMC did not reduce Medicaid spending in the typical state. However, the effects of the shift varied significantly across states as a function of the generosity of the state's baseline Medicaid provider reimbursement rates. These results are consistent with recent research on managed care among the privately insured, which finds that HMOs and other forms of managed care achieve their savings largely through reduced prices rather than lower quantities.
