Ohio Launches Nest Generation Managed Care Plans
The Ohio Department of Medicaid recently launched its Next Generation managed care plans, following an overhauling process that began in 2019.
Healthcare Payers
New Mexico Human Services Department Cancels Procurement for Medicaid MCOs
The New Mexico Human Services Department announced it will cancel the procurement process for the selection of managed care organizations to deliver services to Medicaid Centennial Care members in the state.
ACA Marketplace Enrollment Increased 18% From 2021
HHA announced that Affordable Care Act Marketplace enrollment continues to outpace previous years, with nearly 11.5 million people selecting a health plan nationwide in 2022.
Aetna to Provide $9.3 Million to Support Behavioral Health of Youth in Foster Care
Aetna’s Medicaid plan in West Virginia has granted $9.3 million to 10 community-based organizations in a bid to support the behavioral health and social care needs for children in foster care.
Oklahoma Reissues Medicaid Managed Care RFP After OK Supreme Court Blocked First Attempt
On December 1, 2022, Oklahoma reissued an RFP to implement the Medicaid managed care for a program to be called SoonerSelect and the SoonerSelect Children’s Specialty Program.
Florida Starting Medicaid Managed Care Procurement Process
Florida recently released the Medicaid data book, which must be published at least 90 days before issuing the invitation to negotiate for the statewide Medicaid managed care program.
Despite New Programs, Major Payers Still Spending Less Than 1% on Income on Social Determinants of Health
A study from the Journal of General Internal Medicine found that the six payers with the largest market shares may have spent on average 0.67% of their income in 2021 on social determinants of health.
Lessons Learned from CalAIM: Shared Savings and Shared Risk Model Can Improve Care and Reduce Costs
In this blog, we are looking at lessons learned from CalAIM, specifically how shared savings/shared risk models can improve the quality of care and lower healthcare costs by providing the right incentives
Lessons Learned: CalAIM Integrated Care Plans Can Be Replicated Across States
CalAIM fully integrates physical health, behavioral health, and oral health under one contracted managed care plan. How can this be replicated and beneficial to other states?
Iowa Takes a Second Crack at Managed Care – What is Different This Time?
The Iowa HHS issued a notice of intent to award Medicaid MCO contracts to Molina Healthcare and Amerigroup Iowa Inc. for managed care services for Medicaid members in Iowa. But what makes round two of Iowa’s MCO rollout any different than its failed first attempt?