Question

In an essay, provide how Medicaid Managed Care will or will not save money for a Medicaid State Agency?

Answer 1

Ans) The studies strongly suggest that the Medicaid managed care model typically yields cost savings. The results ranged from 0.5 to 20% savings compared to FFS Medicaid. The studies provide some evidence that Medicaid managed care savings are significant for the Supplemental Security Income and SSI-related population.

-

Submit
STATES COULD SAVE MONEY BY EXPANDING MEDICAID MANAGED CARE
BY HEALTHLEADERS MEDIA STAFF  
MAY 20, 2009

Medicaid managed care is providing a safety net of care coordination to millions of at-risk Americans and is improving patient outcomes and quality of care, while reducing states' healthcare costs, according to a recent Lewin Group report that was prepared for America's Health Insurance Plans.

A state looking to cut Medicaid costs should not reduce benefits or lower payment rates, but should instead expand its managed care program, according to the report.

The Lewin Group released a similar study five years ago and returned to the same subject, achieving similar results. In its latest report, The Lewin Group reported Medicaid managed care health plans improve beneficiaries' access to services and have earned high satisfaction ratings from enrollees, in addition to improving care and saving money.

The researchers pointed out that while nearly half of Medicaid beneficiaries are enrolled in managed care plans, more than 80% of national Medicaid spending is in the fee-for-service setting.

AHIP President and CEO Karen Ignagni says Medicaid managed care plans coordinate care, offer patient outreach not available in fee-for-service Medicaid, provide focused chronic care and disease management programs, offer preventive services, and give non-healthcare assistance to beneficiaries in areas such as finding alternatives to nursing home care.

GET THE LATEST ON HEALTHCARE LEADERSHIP IN YOUR INBOX.
Enter your email

"The bottom line of The Lewin Report is that we are providing high value and cost-effectiveness for states at this time of economic crisis," she says. "At this time, we are providing better quality, more access, and a higher degree of satisfaction to beneficiaries than traditional Medicaid programs. That's quite a legacy."

After analyzing 24 recent studies of Medicaid managed care programs, The Lewin Group reported that:

- The studies strongly suggest that the Medicaid managed care model typically yields cost savings. The results ranged from 0.5 to 20% savings compared to FFS Medicaid.
- The studies provide some evidence that Medicaid managed care savings are significant for the Supplemental Security Income and SSI-related population.
- Various studies demonstrated that states' Medicaid managed care cost savings are largely attributed to decreases in inpatient utilization, which could be linked to care coordination.
- Medicaid managed care plans yielded "noteworthy savings" in pharmacy. In comparing FFS programs' drugs costs versus Medicaid health plans, researchers found the costs per-member per-month were 10% to 15% lower for the private health plans.