Accurate Encounter Data a Must For Medicaid MCO Quality Measurement

With more than 60% of all Medicaid beneficiaries now enrolled in comprehensive, risk-based managed care organizations (MCOs), state Medicaid agencies that want to measure quality of those plans must have quality encounter data. Encounter data capture the items or services received by the member; they are managed care’s equivalent of claims in fee for service. […]

Toward a Model Long-Term Services and Supports System: State Policy Elements

In response to a new Federal initiative to improve the U.S. long-term services and supports (LTSS) system, this commentary discusses an array of policies and practices that could potentially improve LTSS provision by shifting from institutional to community-based services, increasing equity across populations, offering consumers more choice and control, improving conditions for workers and caregivers, […]

Iowa’s Privatized Medicaid in “State of Emergency”

Four months is all it took. In April, when Iowa governor Terry Branstad handed over the state’s Medicaid program to private insurance companies, many questioned his motives. Recent large-scale transitions to privatized Medicaid in states like Florida and Kansas haven’t fared well. The Des Moines Registerwarned, “The health care of a half million people and $4 […]