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Why States Depend On Medicaid Managed Care

posted by Rachad Davis

on April 18, 2016

Roughly 70 percent of Medicaid patients receive benefits from a managed care plan, a percentage that continues to grow. Across the country, states are increasingly turning to Medicaid health plans to provide better quality care and greater value to beneficiaries and their families.

Why? Research shows that Medicaid managed care plans have a proven track record of improved outcomes and lower costs:

  • The State of Washington’s Medicaid Integration Partnership Program reduced inpatient hospital admissions by 17.8 percent from 2007 to 2009.
  • In South Carolina, 63 percent of adults with diabetes who were enrolled in Medicaid health plans received consistent monitoring of their condition. That compares to only 33 percent of adults with diabetes participating health plans under Medicaid fee-for-service (FFS).

Medicaid health plans are essential, in part, because they focus on early detection and prevention as well as manage progression of chronic diseases through treatment, outreach, and educational initiatives. These plans offer more than just health care programs. Amerigroup Iowa provides value-added services such as Boys and Girls Club memberships free of charge for kids age 6 through 18 at participating locations. Children 10 and under and plan members 10 and older are also eligible to receive a preventive dental hygiene kit once per year.

Likewise, AmeriHealth Caritas Iowa has services such as its Bright Start Maternity program, which offers pregnant moms education and support during and after their pregnancy. Beneficiaries also have access to Mission GED, a program that provides motivational coaching as well as payments for fees incurred by members seeking their General Educational Development diploma.

As states and policymakers look for ways to continue improvement of the Medicaid program, it’s likely states still leaning on Medicaid FFS programs will begin to transition to managed care because of the quality, cost effectiveness and accountability these plans provide.