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State Medicaid Programs Bring Managed Care Tenets to Fee for Service

Rising numbers of enrollees in state Medicaid programs have resulted in the increased use of commercial managed care organizations by the states. Research shows that the implementation of these programs has produced mixed results. While many states have implemented managed care principles and have s...

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Detalles Bibliográficos
Autores principales: Keast, Shellie L., Skrepnek, Grant, Nesser, Nancy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10398126/
https://www.ncbi.nlm.nih.gov/pubmed/27015253
http://dx.doi.org/10.18553/jmcp.2016.15050
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author Keast, Shellie L.
Skrepnek, Grant
Nesser, Nancy
author_facet Keast, Shellie L.
Skrepnek, Grant
Nesser, Nancy
author_sort Keast, Shellie L.
collection PubMed
description Rising numbers of enrollees in state Medicaid programs have resulted in the increased use of commercial managed care organizations by the states. Research shows that the implementation of these programs has produced mixed results. While many states have implemented managed care principles and have seen reductions in costs, some basic managed care tenets may not apply to a Medicaid population because of limited financial risk and responsibility. The application of commercial managed care organizations to these populations may not result in additional savings for those states already actively engaged in managed care. As such, the purpose of this article is to provide a synopsis of key managed care principles as applied to state Medicaid programs and discuss issues regarding the optimization of cost, access, and quality for this population.
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spelling pubmed-103981262023-08-04 State Medicaid Programs Bring Managed Care Tenets to Fee for Service Keast, Shellie L. Skrepnek, Grant Nesser, Nancy J Manag Care Spec Pharm Viewpoints Rising numbers of enrollees in state Medicaid programs have resulted in the increased use of commercial managed care organizations by the states. Research shows that the implementation of these programs has produced mixed results. While many states have implemented managed care principles and have seen reductions in costs, some basic managed care tenets may not apply to a Medicaid population because of limited financial risk and responsibility. The application of commercial managed care organizations to these populations may not result in additional savings for those states already actively engaged in managed care. As such, the purpose of this article is to provide a synopsis of key managed care principles as applied to state Medicaid programs and discuss issues regarding the optimization of cost, access, and quality for this population. Academy of Managed Care Pharmacy 2016-02 /pmc/articles/PMC10398126/ /pubmed/27015253 http://dx.doi.org/10.18553/jmcp.2016.15050 Text en © 2016, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Viewpoints
Keast, Shellie L.
Skrepnek, Grant
Nesser, Nancy
State Medicaid Programs Bring Managed Care Tenets to Fee for Service
title State Medicaid Programs Bring Managed Care Tenets to Fee for Service
title_full State Medicaid Programs Bring Managed Care Tenets to Fee for Service
title_fullStr State Medicaid Programs Bring Managed Care Tenets to Fee for Service
title_full_unstemmed State Medicaid Programs Bring Managed Care Tenets to Fee for Service
title_short State Medicaid Programs Bring Managed Care Tenets to Fee for Service
title_sort state medicaid programs bring managed care tenets to fee for service
topic Viewpoints
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10398126/
https://www.ncbi.nlm.nih.gov/pubmed/27015253
http://dx.doi.org/10.18553/jmcp.2016.15050
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