Designing a complaint and grievance system and other member assistance services under Medicaid managed care.
نویسندگان
چکیده
منابع مشابه
Forging community partnerships to improve health care: the experience of four Medicaid managed care organizations.
Some managed care organizations (MCOs) serving Medicaid beneficiaries are actively engaging in community partnerships to meet the needs of vulnerable members and nonmembers. We found that the history, leadership, and other internal factors of four such MCOs primarily drive that focus. However, external factors such as state Medicaid policies and competition or collaboration among MCOs also play...
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OBJECTIVE To determine the impact of Florida's Medicaid Reform Demonstration on per member per month (PMPM) Medicaid expenditures. DATA Florida Medicaid claims data from the two fiscal years before implementation of the Demonstration (FY0405, FY0506) and the first two fiscal years after implementation (FY0607, FY0708) from two reform counties and two nonreform counties. STUDY DESIGN A diffe...
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This Policy Brief is the fourth in a series of reports issued by the George Washington University Center for Health Services Research and Policy that examine the design of separately-administered State Children's Health Insurance Programs (SCHIP) that is, programs that operate directly under the authority of the federal SCHIP statute rather than expansions of state Medicaid programs. These Poli...
متن کاملMonitoring and Evaluating the Delivery of Services Under Managed Care
This overview discusses the importance of monitoring and evaluating the delivery of services under managed care, particularly with respect to assessing access and quality in managed care. It also lists recent Health Care Financing Administration (HCFA) initiatives in this area, and presents an introduction to the articles published in this issue of the Review. The topics addressed by these arti...
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With the creation of the Oregon Health Plan (OHP) in 1994, Oregon placed its Medicaid program under a managed care system. This paper examines the managed care practices of seven health plans serving OHP enrollees between 1996 and 1998. Results indicated that the original vision of integrating substance abuse treatment services with physical care for OHP enrollees evolved into a multilayered, c...
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ورودعنوان ژورنال:
- Issue brief
دوره 7 شماره
صفحات -
تاریخ انتشار 2000