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- Managed Care in Pennsylvania - Medicaid. gov
Pennsylvania began experimenting with various managed care arrangements in the 1970’s, beginning with the introduction of its Voluntary Managed Care Program, a comprehensive risk-based MCO program available to most Medicaid beneficiaries in certain counties in 1972
- Managed Care Entities | Medicaid
Federal Managed Care regulations at 42 CFR 438 recognize four types of managed care entities: Managed Care Organizations (MCOs) Comprehensive benefit package Payment is risk-based capitation Primary Care Case Management (PCCM)
- Managed Care in Puerto Rico - Medicaid. gov
Managed Care in Puerto Rico This profile reflects state managed care program information as of August 2021, and only includes information on active federal operating authorities, and as such, the program start date may not reflect the earliest date that a program enrolled beneficiaries and provided services Some states report populations and services available to program participants under
- Managed Care Quality Improvement | Medicaid
As the dominant delivery system for Medicaid and the Children's Health Insurance Program (CHIP), managed care has enormous potential to achieve state priorities and improve health care quality and outcomes Federal regulations at 42 CFR 438 subpart E (Quality Measurement and Improvement) require states with managed care contracts to carry out a set of managed care quality (MCQ) oversight
- 2024-2025 Medicaid Managed Care Rate Development Guide
a way that the MCO, PIHP, or PAHP would reasonably achieve a medical loss ratio standard greater than 85 percent, as calculated under 42 CFR § 438 8, as long as the capitation rates are adequate for reasonable, appropriate, and attainable non-benefit costs
- Managed Care | Medicaid
Managed Care is a health care delivery system organized to manage cost, utilization, and quality Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services
- Managed Care in Illinois - Medicaid. gov
Managed Care in Illinois This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program start date may not reflect the earliest date that a program enrolled beneficiaries and provided services Some states report populations and services available to program participants under the
- Managed Care in Arizona - Medicaid. gov
Managed Care in Arizona This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program start date may not reflect the earliest date that a program enrolled beneficiaries and provided services Some states report populations and services available to program participants under the
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