Medicaid Managed Care

Expenditures, Screening of Providers, & Utilization Patterns

Buch | Softcover

111 Seiten

2016
Nova Science Publishers Inc (Verlag)
978-1-63485-817-5 (ISBN)

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The importance of managed care in Medicaid -- under which states contract with managed care organisations (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.

Preface; Medicaid Managed Care: Trends in Federal Spending & State Oversight of Costs & Enrollment; Medicaid Program Integrity: Improved Guidance Needed to Better Support Efforts to Screen Managed Care Providers; Medicaid: Service Utilization Patterns for Beneficiaries in Managed Care; Index.

Erscheinungsdatum	07.09.2016
Verlagsort	New York
Sprache	englisch
Maße	155 x 230 mm
Gewicht	198 g
Themenwelt	Medizin / Pharmazie ► Gesundheitswesen
	Studium ► Querschnittsbereiche ► Epidemiologie / Med. Biometrie
	Recht / Steuern ► EU / Internationales Recht
	Recht / Steuern ► Privatrecht / Bürgerliches Recht ► Medizinrecht
	Sozialwissenschaften ► Politik / Verwaltung ► Staat / Verwaltung
ISBN-10	1-63485-817-4 / 1634858174
ISBN-13	978-1-63485-817-5 / 9781634858175
Zustand	Neuware