ACAP Report Details Safety Net Plan Initiatives to Coordinate Care
As state agencies modernize and improve their Medicaid programs, the fee-for-service Medicaid model
is rapidly being replaced with a coordinated care model where capitated state payments are made to
managed care organizations (MCO). In 2011, 30 percent of nationwide Medicaid spending occurred via
capitation—a sharp increase from 2005, when 17 percent of spending was capitated. While initially excluded from states’ capitation initiatives, Medicaid subgroups with higher needs—such as the aged, blind and disabled—are increasingly being served through a coordinated care model.
The Medicaid managed care industry is in the midst of a highly energized period of innovation and thoughtful experimentation. Many Medicaid MCOs have invested resources to improve care coordination programs and engage their enrollees. These mechanisms include comprehensive assessments, individualized care plans, systematic identification of treatment gaps and follow-up efforts to address them, enrollee and provider incentive programs, greater use of emerging technologies such as text messaging, and increased face-to-face interactions.View the full article »