A Holistic, Person-centered Approach To Medicaid Managed Care

posted by AHIP Staff

on January 5, 2016

Recognizing health care is not one-size-fits-all, Medicaid health plans tailor benefits and programs to the specific needs of patient populations. A key component of what makes Medicaid health plans successful is their ability to develop patient-centered programs based on critical input from beneficiaries and providers. This is especially important in the delivery of long-term services and supports (LTSS), which help older adults and adults with disabilities maintain their independence.

Medicaid health plans’ long-term programs employ multiple specialty providers and services, such as community and social supports, to address all of the determinants of a beneficiary’s health, well-being, and quality of life.  This includes using care coordinators who have been trained in integrated behavioral and physical health services and engaging with community-based and faith-based organizations and in-home health and services agencies.

Medicaid health plans devote considerable resources to training their staffs on LTSS benefits and the needs of the beneficiaries these programs serve, all of which is enhanced by direct input from individuals with disabilities and older adults.

Outreach and education initiatives are essential to improving beneficiary access to care.  For example, a lack of health literacy can result in greater challenges for patients as they balance medication requirements, treatment plans, and more. Medicaid health plans have developed easy-to-use materials (in multiple languages) and work with providers to ensure patients understand their diagnosis and treatment regimen before and after they leave the doctor’s office.

Wireless technology, such as mobile texting, is an important tool to help Medicaid beneficiaries improve adherence to their medication regimen, adopt healthy activities such as smoking cessation, and keep their medical appointments. These texting programs significantly increased flu immunization rates among pregnant women, reduced rates of alcohol consumption and smoking, improved levels of glycemic control among pregnant women with diabetes, and decreased patient costs by improving compliance with diabetes management programs.

For more information about Medicaid health plans, click here.

Guest Post by Mark Hamelburg, Senior Vice President, Federal Programs; Howard Weiss, Vice President, Public Programs Policy; and Randy Desonia, Executive Director, Medicaid Policy

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