medicaid managed care organizations report
play

Medicaid Managed Care Organizations Report: Overview Prepared for - PowerPoint PPT Presentation

Aug 10, 2023 •348 likes •441 views

Medicaid Managed Care Organizations Report: Overview Prepared for the Medicaid Oversight and Advisory Committee Carol Steckel, Commissioner Steve Bechtel, DMS Chief Financial Officer November 27, 2018 MCO PROFIT MARGINS 2 3 4 MEDICAL LOSS

  1. Medicaid Managed Care Organizations Report: Overview Prepared for the Medicaid Oversight and Advisory Committee Carol Steckel, Commissioner Steve Bechtel, DMS Chief Financial Officer November 27, 2018

  2. MCO PROFIT MARGINS 2

  3. 3

  4. 4

  5. MEDICAL LOSS RATIO (MLR) 5

  6. 6

  7. 7

  8. 8

  9. QUESTIONS? 9

Download Presentation
Download Policy: The content available on the website is offered to you 'AS IS' for your personal information and use only. It cannot be commercialized, licensed, or distributed on other websites without prior consent from the author. To download a presentation, simply click this link. If you encounter any difficulties during the download process, it's possible that the publisher has removed the file from their server.

Recommend

Medicaid Managed Care Overview ICAAP, Jennie Pinkwater & Dru ORourke ISMS, Ken Ryan

Medicaid Managed Care Overview ICAAP, Jennie Pinkwater & Dru ORourke ISMS, Ken Ryan

Medicaid Managed Care Overview ICAAP, Jennie Pinkwater & Dru ORourke ISMS, Ken Ryan Participating IAFP, Gordana Krkic Organizations IAMHP, Samantha Olds Frey & Cyrus Winnett Medicaid Managed Care Basics In 2011, the

500 views • 30 slides
Medicaid Managed Care Overview Medicaid Managed Care Basics In 2011, the General Assembly passed

Medicaid Managed Care Overview Medicaid Managed Care Basics In 2011, the General Assembly passed

Medicaid Managed Care Overview Medicaid Managed Care Basics In 2011, the General Assembly passed PA 96-1501 2011 to address increasing budget pressures in the Medicaid program, requiring Illinois to enroll 50% Medicaid of its Medicaid

491 views • 28 slides
NC Medicaid Managed Care Webinar Summary Webinar Summary o The NC Medicaid Managed Care

NC Medicaid Managed Care Webinar Summary Webinar Summary o The NC Medicaid Managed Care

NC Medicaid Managed Care Webinar Summary Webinar Summary o The NC Medicaid Managed Care transition and its impact on beneficiaries o The timeline for open enrollment and what to expect in terms of communication to beneficiaries o And how you

767 views • 53 slides
Medicaid Managed Care STAR Expansion Acute Care Provider Training February 2011 What is

Medicaid Managed Care STAR Expansion Acute Care Provider Training February 2011 What is

Medicaid Managed Care STAR Expansion Acute Care Provider Training February 2011 What is Medicaid Managed Care? Establish a medical home for Medicaid clients through a Primary Care Provider (PCP) Emphasize preventative care

452 views • 20 slides
F Progress Report: Centennial Care Waiver and Medicaid Managed Care Costs Jacob Rowberry,

F Progress Report: Centennial Care Waiver and Medicaid Managed Care Costs Jacob Rowberry,

F Progress Report: Centennial Care Waiver and Medicaid Managed Care Costs Jacob Rowberry, Program Evaluator September 30, 2020 1 Background: Centennial Care Waiver Program First iteration of Centennial Care operated between 2014 2018

589 views • 31 slides
Ohio Medicaid Managed Care Procurement Update Medical Care Advisory Committee (MCAC) Thursday,

Ohio Medicaid Managed Care Procurement Update Medical Care Advisory Committee (MCAC) Thursday,

Ohio Medicaid Managed Care Procurement Update Medical Care Advisory Committee (MCAC) Thursday, February 20, 2020 Managed Care Mission Statement Medicaid Managed Care Procurement Project Phases Current Phase RFI #1 RFI #2 Implementation,

445 views • 15 slides
Governors Commission on New Hampshires Medicaid Care Management Program Medicaid Managed

Governors Commission on New Hampshires Medicaid Care Management Program Medicaid Managed

Governors Commission on New Hampshires Medicaid Care Management Program Medicaid Managed Care Financial Considerations Presented by: John D. Meerschaert, FSA, MAAA Principal and Consulting Actuary October 13, 2016 Todays Agenda

408 views • 22 slides
Medicaid and CHIP Managed Care Final Rule (CMS-2390-F) Improving Quality of Care Through

Medicaid and CHIP Managed Care Final Rule (CMS-2390-F) Improving Quality of Care Through

Medicaid and CHIP Managed Care Final Rule (CMS-2390-F) Improving Quality of Care Through External Quality Review and Federal Financial Participation Center for Medicaid and CHIP Services Medicaid Managed Care Final Rule The Medicaid

386 views • 20 slides
Trends in Risk-Based Medicaid Managed Care: A National Overview Julia Paradise Associate

Trends in Risk-Based Medicaid Managed Care: A National Overview Julia Paradise Associate

Trends in Risk-Based Medicaid Managed Care: A National Overview Julia Paradise Associate Director Kaiser Commission on Medicaid and the Uninsured for Medicaid Managed Care in the Era of Health Reform June 25, 2013 Washington, DC Figure 1

436 views • 5 slides
Provider Reviews, Audits and Investigations in Medicaid Managed Care NC Medicaid Office of

Provider Reviews, Audits and Investigations in Medicaid Managed Care NC Medicaid Office of

Provider Reviews, Audits and Investigations in Medicaid Managed Care NC Medicaid Office of Compliance & Program Integrity November 12, 2019 NCDHHS Division of Health Benefits | Provider Reviews, Audits and Investigations in Managed Care |

818 views • 19 slides
to Medicaid Managed Care: Lessons from California Carrie L. Graham, PhD Health Research for

to Medicaid Managed Care: Lessons from California Carrie L. Graham, PhD Health Research for

Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Lessons from California Carrie L. Graham, PhD Health Research for Action UC Berkeley School of Public Health for Medicaid Managed Care in the Era of Health Reform

477 views • 9 slides
Medicaid Managed Care Overview In 2011, the General Assembly passed PA 96-1501 2011 to address

Medicaid Managed Care Overview In 2011, the General Assembly passed PA 96-1501 2011 to address

Medicaid Managed Care Overview In 2011, the General Assembly passed PA 96-1501 2011 to address increasing budget pressures in the Medicaid program, requiring Illinois to enroll 50% Medicaid of its Medicaid population in care coordination

255 views • 21 slides
Partnering with Public Health Departments in THIS AREA CAN BE LEFT BLANK or ADD A Managed Care

Partnering with Public Health Departments in THIS AREA CAN BE LEFT BLANK or ADD A Managed Care

Partnering with Public Health Departments in THIS AREA CAN BE LEFT BLANK or ADD A Managed Care PICTURE 2/3/2017 The Value of Medicaid Managed Care States Have Seen the Value of Medicaid Managed Care 75 Million Americans are covered by a

412 views • 19 slides
Medicaid M Managed Ca Care for I Individuals Enrol olled ed on a DOD ODD Waiver er Office

Medicaid M Managed Ca Care for I Individuals Enrol olled ed on a DOD ODD Waiver er Office

Medicaid M Managed Ca Care for I Individuals Enrol olled ed on a DOD ODD Waiver er Office of Managed Care Ohio Department of Medicaid Summer 2017 O H I O D E PA R T M E M E N T O O F M M E D I C A I D M a k i n g O O h i o B B

858 views • 47 slides
Medicaid Managed Care Samantha Olds Frey Executive Director Illinois Association of Medicaid

Medicaid Managed Care Samantha Olds Frey Executive Director Illinois Association of Medicaid

Medicaid Managed Care Samantha Olds Frey Executive Director Illinois Association of Medicaid Health Plans Illinois Association of Medicaid Health Plans Medicaid Care Coordination Programs Integrated Care Program Serves Seniors and

327 views • 16 slides
Claim submission guidelines for LTC/SNFs to Managed Care Organizations that participate in MMAI

Claim submission guidelines for LTC/SNFs to Managed Care Organizations that participate in MMAI

Claim submission guidelines for LTC/SNFs to Managed Care Organizations that participate in MMAI and/or ICP Presented by: The Illinois Association of Medicaid Health Plans 1 Identifying Identifying the correct payer source the correct payer

662 views • 55 slides
Insurance Market ARIZONA DEPARTMENT OF INSURANCE OCTOBER 2018 Topics: Arizonas 2019

Insurance Market ARIZONA DEPARTMENT OF INSURANCE OCTOBER 2018 Topics: Arizonas 2019

2019 Health Insurance Market ARIZONA DEPARTMENT OF INSURANCE OCTOBER 2018 Topics: Arizonas 2019 Individual Marketplace When & how to submit Complaints to ADOI Renewing Navigator/CAC license with ADOI Understanding Non-ACA

651 views • 15 slides
NEW LEDGER REVIEW SYSTEM TRAINING MANAGEMENT LEDGER REVIEW (MLR) JULY 2015 JIM HEWLETT ANALYST

NEW LEDGER REVIEW SYSTEM TRAINING MANAGEMENT LEDGER REVIEW (MLR) JULY 2015 JIM HEWLETT ANALYST

NEW LEDGER REVIEW SYSTEM TRAINING MANAGEMENT LEDGER REVIEW (MLR) JULY 2015 JIM HEWLETT ANALYST Note on this Training This training module focuses on details and functionality of Management Ledger Review (MLR) and how to interpret and

549 views • 33 slides
Amerigroup Louisiana, Inc. 1 Agenda Introduction Behavioral Health Member-PCP

Amerigroup Louisiana, Inc. 1 Agenda Introduction Behavioral Health Member-PCP

Amerigroup Louisiana, Inc. 1 Agenda Introduction Behavioral Health Member-PCP Alignment Clinic Days Provider Quality Incentive Program Potential Missed Care Opportunities 2 Behavioral health Effective December 1,

659 views • 33 slides
PPACA HEALTH REFORM UPDATE MEDICAL LOSS RATIO AND REBATE REQUIREMENTS SHRM GUAM CHAPTER MONTHLY

PPACA HEALTH REFORM UPDATE MEDICAL LOSS RATIO AND REBATE REQUIREMENTS SHRM GUAM CHAPTER MONTHLY

PPACA HEALTH REFORM UPDATE MEDICAL LOSS RATIO AND REBATE REQUIREMENTS SHRM GUAM CHAPTER MONTHLY MEETING 06 JUNE 2012 AGENDA Summary of Law Definitions Reporting Requirements Calculating Medical Loss Ratio Premium Rebates Notification

718 views • 26 slides
Medicaid Managed Care Final Rule: Calculating Medical Loss Ratio, Complying With Network Adequacy

Medicaid Managed Care Final Rule: Calculating Medical Loss Ratio, Complying With Network Adequacy

Presenting a live 90-minute webinar with interactive Q&A Medicaid Managed Care Final Rule: Calculating Medical Loss Ratio, Complying With Network Adequacy Standards and More WEDNESDAY, AUGUST 3, 2016 1pm Eastern | 12pm Central |

729 views • 49 slides
Water safe ----Providing you safe water Detection and degradation of Microcystin LR By

Water safe ----Providing you safe water Detection and degradation of Microcystin LR By

Water safe ----Providing you safe water Detection and degradation of Microcystin LR By Jilin_China Directory Our team Water Project Safe Human practice Jilin-China Acknowledgement Our 1 Team Team We come from Jilin University,

661 views • 42 slides
Update to Copper Criteria for Aquatic Life Use April 20, 2016 Idaho Department of Environmental

Update to Copper Criteria for Aquatic Life Use April 20, 2016 Idaho Department of Environmental

Negotiated Rulemaking Docket No. 58 0102 1502 Update to Copper Criteria for Aquatic Life Use April 20, 2016 Idaho Department of Environmental Quality Outline Review of previous rulemaking meetings Review of comments received

600 views • 55 slides
Alternative Payment Methodology Advisory Committee FIRST MEETING OCTOBER 18 TH 2016 OFFICE OF

Alternative Payment Methodology Advisory Committee FIRST MEETING OCTOBER 18 TH 2016 OFFICE OF

Alternative Payment Methodology Advisory Committee FIRST MEETING OCTOBER 18 TH 2016 OFFICE OF THE HEALTH INSURANCE COMMISSIONER Agenda Introductions Review of APM Data Minimum Downside Risk Commonly Defined Episodes of Care

581 views • 30 slides

More recommend