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New Study: Innovation Improves Care Delivery For Medicaid Managed Care Plans

posted by AHIP

on May 6, 2020

Analysis by The Menges Group finds that innovative solutions from Medicaid managed care plans expand access to doctors and improve quality of care

WASHINGTON, D.C. – Americans with Medicaid deserve high-quality coverage and care. As part of their commitment to serving Medicaid enrollees and ensuring their access to high-quality care, Medicaid managed care plans have been developing innovative, cutting-edge programs that are improving care delivery and benefits for enrollees. That’s according to new research from The Menges Group, conducted on behalf of America’s Health Insurance Plans (AHIP).

These findings are particularly important as Americans continue to come together to fight the COVID-19 crisis. About 1 in 5 Americans rely on Medicaid for their health care coverage today, with two-thirds of enrollees served by a Medicaid managed care health plan. Medicaid enrollment could increase by 11 to 23 million as a result of COVID-19. Health insurance providers are working with federal, state and local leaders to overcome the crisis, and they remain committed to delivering access to high-quality care and innovations to improve health and outcomes that Medicaid managed care enrollees deserve.

The major takeaways from today’s study include:

  • Medicaid managed care plans are creating and covering telehealth programs that expand access to care and increase the ability of doctors to coordinate care for patients. These solutions address rural access to care, behavioral health services, and chronic pain management.
  • Medicaid managed care plans are demonstrating breakthrough programs to reduce social and financial barriers to health, such as deploying mobile produce markets with fresh vegetables to neighborhoods with limited supermarket access, or teaching enrollees with chronic health conditions how to cook healthy meals.
  • Medicaid managed care plans are improving the ways enrollees can access provider networks, including creating tools that allow enrollees to more easily locate doctors in their networks, view practice information, and rate their doctors.

Today’s announcement marks the third of a series of studies on the performance of Medicaid managed care plans conducted by The Menges Group for AHIP. Additional studies will cover the value plans bring to states, as well as their financial performance.

Leveraging Innovation to Improve Patient Care

Medicaid managed care plans are working with state Medicaid agencies to develop innovative programs that are improving both access and quality of care for Medicaid enrollees – especially as America continues to battle COVID-19. Whether expanding access to telehealth, operating community resource hotlines, allowing enrollees to rate their doctors, or integrating behavioral and physical health, Medicaid managed care plans are committed to providing the health care their enrollees need and deserve.

Medicaid managed care plans are responsible stewards of taxpayer dollars. They perform a significant range of network management, care management, and operational functions for states while controlling Medicaid program costs and delivering high quality coverage, demonstrating how efficiently and effectively they serve Medicaid enrollees and hardworking taxpayers.

“Medicaid managed care plans are creating innovative programs that are breaking down social barriers to health and resulting in better patient care,” said Matt Eyles, AHIP President and CEO. “These cutting-edge programs are providing enrollees with better access to doctors and enhancing overall care coordination. Now more than ever, Medicaid is an essential safety net for American families. Medicaid managed care plans are once again delivering the high-quality health care Americans need and deserve.”

From innovation to quality to prescription drug delivery, Medicaid managed care is focused on putting people with Medicaid first and delivering the quality and value they deserve.

Read the full study.


* Note: The National Committee for Quality Assurance (NCQA) is an independent organization that studies how well health plans and doctors provide scientifically recommended care. NCQA administers a number of major healthcare quality measurement programs, including HEDIS (Healthcare Effectiveness Data and Information Set) and the CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey.

About AHIP

AHIP is the national association whose members provide coverage for health care and related services to hundreds of millions of Americans every day. Through these solutions, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access, and well-being for consumers. Visit www.ahip.org for more information.

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