September 24, 2018
Medicaid health plans help millions of Americans access quality health care services, increasing the importance and popularity of coordinated care among states and enrollees. AHIP’s Medicaid policy leads, Mark Hamelburg and Rhys Jones, weigh in to share more insight on the value that the program continues to bring year after year.
States rely on Medicaid health plans to promote high-quality, coordinated care for their growing Medicaid populations for three primary reasons:
States have seen a wide range of benefits for people with Medicaid. New Mexico saw hospital admissions reduced 19 percent, nursing facility use reduced by 17 percent, and emergency department visits reduced by eight percent after implementing a managed long-term services and supports program for adults with disabilities and older adults.
In South Carolina, adults with diabetes covered by Medicaid health plans were more likely to receive consistent monitoring and support for their condition. Sixty-three percent of adults covered by a Medicaid health plan monitored their blood sugar, compared to 33 percent of adults covered by Medicaid fee-for-service (FFS).
Additionally, in Georgia, children enrolled in Medicaid health plans are more than twice as likely to experience six or more well-child visits during the first 15 months of life.
As states and policymakers look to sustain the Medicaid program, health plans’ programs and tools can help lead transformations that impact the larger health care delivery system. According to a recent survey of Medicaid health plans, 93 percent of plans now pay some of their providers based on quality and performance. The focus of Medicaid health plans on detecting and preventing the progression of chronic diseases, coordinating services across the continuum of care, and delivering programs targeted to individual needs are significantly improving quality and outcomes for low-income Americans.