Bipartisan Leaders Seek Best Practices for Medicaid Managed Care Plans

29 Sep Bipartisan Leaders Seek Best Practices for Medicaid Managed Care Plans

gov-buildingMembers of the House Energy and Commerce Committee and Senate Finance Committee sent out a letter to associations serving Medicaid health plans in pursuit of suggestions on best practices connected to cost controls, the use of data and quality of care. The leaders want to gain a better understanding of the function of managed care plans in Medicaid and learn from effective methods utilized to provide for different communities covered within the program.

The document reads, “Today, the Medicaid program provides health coverage to more than 67 million people, with over half of those individuals receiving coverage through a private managed care plan that contracts with a state’s Medicaid program. As a result, we believe it is important for Congress to better understand the growing and evolving role managed care plays in the Medicaid program. … Given the emerging diversity and growth within the program, we are particularly interested in providing private sector partners the opportunity to benefit from the consideration of an array of successful models for patient care.”.

One particular focus of the letter, specifically, is guidance on practical approaches to enhance program integrity and prevent incorrect payments, including the use of data and analytics.

The documents were sent out to the Medicaid Health Plans of America, the Association for Community Affiliated Plans, and America’s Health Insurance Plans and were signed by House Energy and Commerce Committee Chairman Fred Upton (R-MI) and Ranking Member Henry A. Waxman (D-CA) and Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Orrin Hatch (R-UT).

Read the full letter