Expanding managed care is one way Texas hopes to save money. One of ten states with specific expansion plans, Texas seeks to find a balance between cost reduction and quality care as the health care reform law, which will increase the Medicaid rolls, goes into effect. An excerpt from Kaiser Health News:
Nearly every state uses managed care to some extent, and as of October 2010, about 66 percent of Medicaid enrollees were in managed-care plans of some type, according to the survey. That includes state-operated programs that pay primary care doctors bonuses to soup up care management. Many states that already require children and some adults to enroll in private plans are expanding managed care to higher cost populations such as the elderly.
The need to rein in Medicaid spending is expected to be amplified in 2014, when 16 million more people will be covered by the program as a result of the 2010 federal health law. Of the 30 states that responded to that question, 20 states said they expected Medicaid managed care plans to be able to absorb that influx. One state expressed doubt, and nine did not know whether plans were prepared for the new members.
With budget fears percolating in Washington, too, the health plans are hoping they can bring states’ enthusiasm for Medicaid managed care to the federal government.
This week, a group of managed care plan executives and lobbyists, organized by the Association for Community Affiliated Plans, were in Washington to bring the argument to lawmakers that their industry can help extract needed savings from the Medicaid program. The group opposes Medicaid funding cuts, but its members stand to gain if federal lawmakers – like their state counterparts – turn to managed care for savings.
The Texas Watchdog has more information about the managed care expansion in the Rio Grande Valley.