Medicare vs. Medicaid: A Quick Recap and Reference Guide
You likely hear a lot about Medicare, Medicaid, and Medicare Advantage, but do you know what the difference between the programs is?
managed care
NC Medicaid Beneficiaries with Disabilities At Risk if Health Care Providers Don’t Sign With MCOs
NC consumers who use Medicaid and have severe mental illness, substance use disorders or developmental disabilities might have to switch doctors soon if their providers don’t sign contracts with new managed care plans.
Female-Founded Health Tech Startup Addressing SDOH
Spatially Health, a female-founded health tech startup, teamed up with ACO Health Partners in Florida to address social determinants of health.
Value-Based Care Platform Joining CMS Advance Investment Payments (AIP) Incentive Program
Federally qualified health centers (FQHCs) and rural providers participating in ACOs using the Signify Health platform will receive advanced incentive payments when they join the Medicare Shared Savings Program.
Ohio Launches Nest Generation Managed Care Plans
The Ohio Department of Medicaid recently launched its Next Generation managed care plans, following an overhauling process that began in 2019.
New Mexico Human Services Department Cancels Procurement for Medicaid MCOs
The New Mexico Human Services Department announced it will cancel the procurement process for the selection of managed care organizations to deliver services to Medicaid Centennial Care members in the state.
Oklahoma Reissues Medicaid Managed Care RFP After OK Supreme Court Blocked First Attempt
On December 1, 2022, Oklahoma reissued an RFP to implement the Medicaid managed care for a program to be called SoonerSelect and the SoonerSelect Children’s Specialty Program.
Florida Starting Medicaid Managed Care Procurement Process
Florida recently released the Medicaid data book, which must be published at least 90 days before issuing the invitation to negotiate for the statewide Medicaid managed care program.
House Lawmakers Requesting Extension of Value-Based Payment Incentives
More than 40 House lawmakers signed a letter asking congressional leaders to support value-based payment incentives and extend the 5% bonus for Alternative Payment Model (APM) participation.
CalOptima Health Integrating Care Through School District Partnerships
CalOptima says managed care plan partnerships with school districts across Orange County will increase behavioral health care access for children and youth and increase preventative and early intervention behavioral health care.