Hidden Benefits: The Value of Medicaid Managed Care Networks
Medicaid managed care plans employ an array of network enhancing strategies — such as technology-based innovations, provider collaboration, value-based payment, and non-traditional providers — to increase access to and quality of care for beneficiaries. These innovations help individuals obtain the full array of services they need.
As states increasingly enroll Medicaid beneficiaries with more complex and diverse needs into managed care plans, traditional measures of network adequacy — such as physician-to-enrollee ratios or time and distance standards — are important but not adequate. They paint an incomplete picture of how plans enhance network access and delivery of care.
These measures do not reflect how Medicaid managed care plans, working with their provider and state partners, employ strategies that minimize access barriers, embrace new technologies, and create incentives for providers to deliver cost-effective, patient-centered care. Nor do the measures recognize the efforts directed at individuals with multiple or complex conditions or that support individuals who are geographically isolated.
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Medicaid and a Health Home Approach for Children on the Autism Spectrum
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Medicaid Managed Care Delivers Value and Efficiency to States
Findings from the literature demonstrate that, compared to FFS, Medicaid managed care improves quality and individuals’ experience, enhances access to care, and helps states manage costs.
Value-Based Care Models for Mental Health and Substance Use Services in Medicaid
Medicaid MCOs are increasingly adopting value-based care models that incentivize an integrated approach to the identification and treatment of MH/SUD, along with physical health conditions.