Medicaid: States' Efforts to Educate and Enroll Beneficiaries in Managed Care (MC)Given the expansion of Managed Care (MC) & reports of abuses, this report: describes the role of marketing in expanding participation in MC & the types of marketing & enroll. abuses that have occurred; identifies state efforts to curb or prevent these abuses & to ensure that beneficiaries are adequately informed about their health plan options & MC as a service delivery approach; & identifies state efforts to measure the effective. of their educ. & enroll. approaches. In FY Ô95, Fed. & state Medicaid expenditures reached $150 billion & accounted for more than 19% of state budgets. |
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addition AFDC AFDC-related allows MCOS assignment rate assist beneficiaries beneficiaries about managed beneficiaries in managed beneficiaries select beneficiaries understand choice counseling choosing a plan Contract Requirements Contracts in Missouri Corrective Actions counties Disenrollment Abuses education and enrollment eligibility enroll in managed enrollees enrollment abuses enrollment activities Enrollment Broker Contracts enrollment efforts enrollment functions enrollment process enrollment responsibilities enrollment strategies example fee-for-service Florida four HCFA health plan help beneficiaries implementation in-person meetings inform beneficiaries mail and telephone managed care plans managed care programs managed care system mandatory managed mandatory program marketing and enrollment Maryland measure the effectiveness Medicaid beneficiaries Medicaid managed Medicaid managed care Minnesota Missouri and Ohio move to mandatory Per-enrollment percent primary care provider provide beneficiaries Provide enrollment counselors public assistance offices sales agents select an MCO states-California statewide Supplemental Security Income switch MCOS Table III.2 telephone contacts Tennessee toll-free telephone lines uninsured Virginia Commonwealth University visited Washington
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Page 3 - QI be located in such an area and meet each of three criteria set forth in regulations published by the Health Care Financing Administration (-HCFA-) in the Department of Health and Human Services (-HHS-).
Page 2 - For more detailed information on our scope and methodology, see appendix I.
Page 1 - The Honorable William S. Cohen Chairman, Special Committee on Aging United States Senate Dear Senator Cohen: Today, an increasing number of Americans need long-term care.
Page 4 - Medicaid Managed Care: Serving the Disabled Challenges State Programs (GAO/HEHS-96136, July 31, 1996).
Page 1 - Medicald expenditures accounted for more than 20 percent of state budgets. To help control expenditures and expand access to health care. 36 states have mandated enrollment for some portion of their Medicald population In managed care programs.