What’s old is new again. But Twin Peaks and neon accents aren’t the only ‘90s trends enjoying a revival.
Medicaid departments across the country are revisiting managed care as they search for a way to control costs.
Here in Colorado, record-high Medicaid enrollment has some people wondering if this old concept could work for our state, too.
It’s an idea that Colorado has tried in the past and largely abandoned in the wake of legal wrangles.
But a new Colorado Health Institute report finds that the state’s Medicaid department is using managed care techniques in three programs:
- The Accountable Care Collaborative, which covers 1.3 million enrollees across the state, contracts with third party organizations to coordinate care and encourages the use of a medical home.
- Medicaid Prime, administered by Rocky Mountain Health Plans to 38,000 enrollees in six Western Slope counties, takes this a step further by also paying a set per-person amount to providers for primary care.
- Denver Health Medicaid Choice is the furthest along the Medicaid managed care path, paying a set per-person amount for nearly all medical services to 89,000 enrollees in the Denver Metro area.
In addition, behavioral health organizations in the state provide mental health services to all Medicaid enrollees for a set per-person amount, also a managed care model.
The new report looks at these programs, how they’ve worked so far — and whether they’ve gone far enough. Future research planned by CHI will delve into the experience of other states and quantify the potential savings and costs of a full managed care approach in Colorado.
Many questions remain. Is Medicaid managed care the right fit for Colorado? What would the impact be on health care costs and quality? Will our Beanie Baby collections finally appreciate?
Stay tuned to future reports in the new CHI series.