Managed Care

Managed Care

Redirecting Medicaid MCO Gains to Offset Network Provider Losses in the Time of COVID-19

2020 Q2 marked the arrival of the coronavirus pandemic, stay-at-home orders, school closures, social distancing, and a recession.  Families put off going to the doctor’s office for routine, non-emergency care.  Primary care physician practices and clinics that bill for each visit saw sharp drops in their revenues as patients stayed at home (pediatricians’ offices were […]

COVID-19, State Budget Deficits, and Medicaid Managed Care

The COVID-19 pandemic has unleashed not just death, but also massive unemployment and a steep recession.  Among the economic casualties are state budgets, which have been knocked badly out of balance by the resulting drop in revenues and the prospect of increased enrollment in Medicaid and other safety net programs.   Among those spared from the […]

Taxing Medicaid Managed Care to Mitigate Medicaid Cuts

In many states, Medicaid is under budgetary siege.  The steep recession brought on by the COVID-19 pandemic has led to large revenue shortfalls and budget deficits, most notably an estimated $54 billion in California for the fiscal year ending June 30 and the next.  States must balance their budgets, and they have only a few […]

Medicaid Managed Care Transparency: A Leap Forward

The California Health Care Foundation has just issued a path-breaking report that marks an important step forward on the road to full transparency about Medicaid managed care.  The report, prepared by Dr. Andrew Bindman and his colleagues at the University of California at San Francisco, examines the performance of managed care plans (MCPs) in Medi-Cal […]

Real Protections for Kids and Families in the Newest Texas Medicaid Managed Care Laws

In June 2018, the Dallas Morning News began publishing a series of in-depth investigative reports on Texans harmed through Medicaid managed care, potential conflicts of interest, and weaknesses in oversight and enforcement of Medicaid managed care contracts. The articles resulted in public hearings in the Texas House of Representatives that further explored the issues and allowed the public to comment. In […]