Medicaid managed care under the microscope

Apr 28 2011

News outlets explore the challenges states face as they increasingly try to move recipients into managed care plans in order to control costs and brace for upcoming expansions.

Health News Florida: For Medicaid Moms, Change Coming
As lawmakers hammer out the details, patient advocates have raised concerns about groups that may be tripped up by the complexity of managed-care rules: the developmentally disabled, the mentally ill and frail elders in nursing homes. Not much has been said about pregnant women, even though more than half of them in Florida depend on Medicaid to pay the bills according to Agency for Health Care Administration data (Davis, 4/27).

Kaiser Health News: Insurers Clash With Providers As States Expand Medicaid Managed Care
Kaiser Health News staff writer Phil Galewitz reports: "About half of the nation's 50 million Medicaid recipients are in private managed care plans, which the states typically pay a set amount each month per patient. These plans limit patients' choice of doctors and hospitals. The other half has more freedom to choose where to go for medical care, with the Medicaid program paying a fee for each visit and procedure" (Galewitz, 4/26).