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What You Need To Know About Health Plans And The Medicaid Program

posted by Alicia Caramenico

on March 21, 2016

Medicaid  health plans are uniquely positioned to assist in strengthening the Medicaid program for millions of beneficiaries across the country. A new issue brief from AHIP helps explain the Medicaid program works and how health plans work with states to deliver care for Medicaid beneficiaries. Some of the areas addressed include:

What is Medicaid?

Congress established the Medicaid program in 1965 to serve as a health care safety net for low-income Americans. Today, Medicaid is the largest federal health program in the country, serving more 70 million individuals.

Who and What is Covered?

The Medicaid program is a vital source of coverage for low-income beneficiaries and those suffering from chronic conditions. It is designed to provide comprehensive benefits to populations with complex health issues, and beneficiaries often benefit from assistance with non-medical related needs like stable housing arrangements, employment, and adequate nutrition. Key elements of Medicaid programs, such as the scope of benefits, vary from state to state.

What Role Do Managed Health Plans Play in the Medicaid Program?

Medicaid health plans are fundamental to the operation of the Medicaid program, enrolling approximately 70 percent of all Medicaid beneficiaries. Innovations pioneered by these health plans are demonstrating improved outcomes for beneficiaries and are serving as the model for national proposals to improve quality of care. By  providing integrated systems of care, health education outreach, disease management programs, social services, and developing partnerships with community groups, Medicaid managed health plans are  improving access for beneficiaries and providing cost savings to states.

You can read the full issue brief here.