Provider Networks and Access in Medicaid Managed Care

Medicaid Managed Care Network Adequacy & Access - KFF

Recent research findings suggest that provider network directories may overstate Medicaid physician availability and current network adequacy ...

Medicaid depends on managed care. In 2016, more than 65 million Medicaid beneficiaries — about 80 percent — were enrolled in managed care.

In Medicaid Managed Care Networks, Care Is Highly Concentrated ...

beneficiaries may have preferences for providers not included in plans' networks.13–15 States at- tempt to ensure access in Medicaid by ...

A Closer Look at the Access Provisions in Final Medicaid Managed ...

An adequate provider network is essential to access care for people enrolled in Medicaid MCOs, but other factors affect their access to care ...

New Opportunities to Strengthen Medicaid Managed Care Network ...

Research suggests that narrow networks are associated with less access to specialists, particularly those delivering behavioral health or cancer ...

Medicaid Managed Care Plans and Access to Care - KFF

Plan efforts to recruit and maintain their provider networks can play a crucial role in determining enrollees' access to care through factors ...

Medicaid and Children's Health Insurance Program Managed Care ...

... beneficiaries' access to high-quality care, ensure adequate provider payment, and provide comprehensive program monitoring and oversight.

Medicaid and CHIP Managed Care Monitoring and Oversight Initiative

... access to these critical services through robust provider networks. This toolkit aims to help state Medicaid agencies and the managed care plans with which ...

Monitoring managed care access - MACPAC

Network providers must offer hours of operation no less than those offered to commercial beneficiaries or comparable to Medicaid FFS, and must ...

Variation in Network Adequacy Standards in Medicaid Managed Care

Our findings suggest one important reason: current network adequacy standards largely rely on single dimensions of access, like travel time or distance, without ...

In Medicaid Managed Care Networks, Care Is Highly Concentrated ...

Our findings suggest that current network adequacy standards might not reflect actual access; new methods are needed that account for beneficiaries' preferences ...

Promoting Access in Medicaid and CHIP Managed Care

Pro- moting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring. Provider Network Adequacy and Service Availability. Baltimore, MD: ...

Provider Networks and Access in Medicaid Managed Care

To ensure people enrolled in Medicaid managed care plans have appropriate access to health services, the Centers for Medicare and Medicaid ...

States Could Better Leverage Coverage and Access Requirements ...

States are not leveraging managed care provider coverage requirements and network adequacy standards to promote access to maternal health care.

Why did they do it that way? Understanding managed care

The two main delivery system models are fee-for-service, where the Medicaid agency directly pays providers or groups of providers, and capitated ...

An Explanation of Final Medicaid Managed Care and Access Rules

The Managed Care Rule addresses five primary areas: access in managed care, including network adequacy; state directed payments; medical loss ...

Summary of CMS's Access-Related Notices of Proposed Rulemaking

This is particularly critical given that over 70 percent of the Medicaid and CHIP populations are enrolled in managed care plans. The Managed ...

Managed Care Health Plans - myDSS - MO.gov

Provider Network Adequacy Standards Report. External Quality Reviews. 2021 ... Managed Care Network Access. Data related to which healthcare providers and ...

Promoting Access in Medicaid and CHIP Managed Care: Behavioral ...

This toolkit aims to help state Medicaid agencies and the managed care plans with which they contract meet the network adequacy requirements for behavioral ...

Managed care's effect on outcomes - MACPAC

They generally limit MCO enrollees to a network of providers. MCO provider networks must be sufficient to provide adequate access to all ...