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Unique Medicaid survey breaks new research ground, capabilities of managed care unveiled

October 22, 2018

Unique Medicaid survey breaks new research ground, capabilities of managed care unveiled
Results highlight benefits Medicaid MCOs bring in value-based payment, women’s health, other key domains

Washington, DC – October 22, 2018 – The Institute for Medicaid Innovation (IMI), the non-profit Medicaid research group, launched a first-of-its-kind national, longitudinal survey that collected information from Medicaid managed care organizations (MCOs) on seven critical health dimensions, demonstrating the capabilities of the industry in these areas.

With the support and encouragement of the board of directors of Medicaid Health Plans of America (MHPA), the managed Medicaid industry trade group, the IMI’s survey tapped a wide cross-section of Medicaid plans, with experts in Medicaid managed care sharing information on high-risk care coordination, pharmacy, value-based payment (VBP), behavioral health, women’s health, child and adolescent health, and long-term services and supports. The IMI and the MHPA board recognized how collecting quality data over time will add to the repository of knowledge on these key issues, which ultimately will benefit Medicaid enrollees, states, and taxpayers, as well as foster further innovation in the Medicaid program.

Especially noteworthy were the findings in high-risk care coordination, value-based payment models, women’s health, and behavioral health. Results in the high-risk care coordination domain showed that the majority of Medicaid MCOs performed a common set of core functions like developing a plan of care for members, supporting adherence to that plan of care, using a care team to address member needs, and conducting risk assessments. On value-based payment, the survey found that a majority of Medicaid MCOs are using VBP models more and more when providing care for their members. Regarding women’s health, findings showed that although many women’s health issues were not seen as being a significant need among members, most MCOs still offered programs and engagement strategies in women’s health. Finally, behavioral health’s integration with physical health emerged as a key challenge for Medicaid MCOs, with top barriers being limitations on the sharing of substance use disorder treatment information, access to behavioral health providers in select regions (e.g., rural), and access to data between care management and behavioral health teams.

“Currently, there is dearth of national data on Medicaid managed care organizations, so we saw a crucial need, especially as policymakers consider options for Medicaid reform, to have accurate and timely data about Medicaid and managed care,” said Jennifer E. Moore, PhD, RN, executive director of IMI.  “We designed the survey to be an annual collection of data to allow for trend analysis.  We hope that this and future reports are able to inform the public, policymakers, clinicians, and researchers as we all work to improve the care of the underserved.”

About the IMI 
The Institute for Medicaid Innovation (IMI) is a 501(c)3 nonprofit research organization that provides independent, nonpartisan information and analysis that informs Medicaid policy and improves the health of the nation.


Media contact:
Lydia Tonkonow