Download or read book Medicaid Managed Care Trends in Federal Spending and State Oversight of Costs and Enrollment written by Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-28 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: "analyzed federal data on Medicaid expenditures for comprehensive risk-based managed care. GAO selected eight states because they used managed care for some portion of their Medicaid population and were geographically diverse. For these states, GAO reviewed state payment data and documentation, including contracts with MCOs, and interviewed state officials. GAO also reviewed federal laws to describe MLR minimums in Medicare and the private insurance market. The Department of Health and Human Services had no comments on this report. What GAO Found Federal spending for Medicaid managed care increased significantly from fiscal year 2004 through fiscal year 2014 (from $27 billion to $107 billion), and represented 38 percent of total federal Medicaid spending in fiscal year 2014. Consistent with this national trend, managed care as a proportion of total federal Medicaid spending was higher in seven of eight selected states in fiscal year 2014 compared with fiscal year 2004. Federal Expenditures for Medicaid Managed Care as a Percentage of Federal Medicaid Expenditures, in Eight States, Fiscal Years 2004 and 2014 Total and average per beneficiary payments by states to managed care organizations (MCOs) varied considerably across the eight selected states in state fiscal year 2014. For example, total payments ranged from $1.3 billion in one state to $18.2 billion in another, and average payments per beneficiary ranged from about $2,800 to about $5,200. While not required by federal policy to do so, five of the eight selected states required MCOs to annually meet minimum medical loss ratio (MLR) percentages-standards that ensure a certain proportion of payments are for medical care and, in effect, limit the amount that can be used for administrative cost and profit. These state minimums generally ranged from 83 to 85 percent, similar to the 85 percent minimums established in the Patient Protection and Affordable Care Act (PPACA) for other sources of health coverage. All MCOs in the five states had MLRs in state fiscal year 2014 that were above the state-required minimums. GAO also found that all eight selected states focused on beneficiary factors, such as assigning a beneficiary to the same managed care plan in which a family member is enrolled, when the state selects a plan for the beneficiary in the absence of the beneficiary choosing a plan-referred to as auto assignment. States also considered plan performance, for example, on quality measures and program goals, such as achieving a certain distribution of enrollment across plans. Auto assignments of beneficiaries ranged from 23 to 61 percent of managed care enrollees across the seven selected states that tracked such data. View GAO-16-77. For more information, contact Carolyn L. Yocom at (202) 512-7114 or [email protected]. Letter"
Download or read book Medicaid Managed Care Trends in Federal Spending and State Oversight of Costs and Enrollment Report to Congressional Requesters written by United States. Government Accountability Office and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Future of the Public s Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Download or read book Medicaid Managed Care written by Carolyn L. Yocom and published by . This book was released on 2015-02-20 with total page 49 pages. Available in PDF, EPUB and Kindle. Book excerpt: The importance of managed care in Medicaid -- under which states contract with managed care organizations (MCOs) to provide a specific set of services -- has increased as states expand eligibility for Medicaid under the Patient Protection and Affordable Care Act (PPACA) and increasingly move populations with complex health needs into managed care. States have flexibility within broad federal parameters to design and implement their Medicaid programs, and therefore play a critical role in overseeing managed care. This report analyzes (1) federal expenditures for Medicaid managed care and the range in selected states' payments made to MCOs; (2) selected states' medical loss ratio (MLR) standards and how they compare with federal standards for other sources of health coverage; and (3) selected states' methods for automatically assigning Medicaid beneficiaries to MCO plans. Tables and figures. This is a print on demand report.
Download or read book Medicaid Managed Care written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-12-24 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: MEDICAID MANAGED CARE: Trends in Federal Spending and State Oversight of Costs and Enrollment
Download or read book Medicaid Hospital Payment written by Jennifer Baldwin and published by . This book was released on 1991 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Monthly Catalog of United States Government Publications written by United States. Superintendent of Documents and published by . This book was released on 1993 with total page 954 pages. Available in PDF, EPUB and Kindle. Book excerpt: February issue includes Appendix entitled Directory of United States Government periodicals and subscription publications; September issue includes List of depository libraries; June and December issues include semiannual index
Download or read book Monthly Catalogue United States Public Documents written by and published by . This book was released on 1993-08 with total page 956 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Rising Above the Gathering Storm written by Institute of Medicine and published by National Academies Press. This book was released on 2007-03-08 with total page 590 pages. Available in PDF, EPUB and Kindle. Book excerpt: In a world where advanced knowledge is widespread and low-cost labor is readily available, U.S. advantages in the marketplace and in science and technology have begun to erode. A comprehensive and coordinated federal effort is urgently needed to bolster U.S. competitiveness and pre-eminence in these areas. This congressionally requested report by a pre-eminent committee makes four recommendations along with 20 implementation actions that federal policy-makers should take to create high-quality jobs and focus new science and technology efforts on meeting the nation's needs, especially in the area of clean, affordable energy: 1) Increase America's talent pool by vastly improving K-12 mathematics and science education; 2) Sustain and strengthen the nation's commitment to long-term basic research; 3) Develop, recruit, and retain top students, scientists, and engineers from both the U.S. and abroad; and 4) Ensure that the United States is the premier place in the world for innovation. Some actions will involve changing existing laws, while others will require financial support that would come from reallocating existing budgets or increasing them. Rising Above the Gathering Storm will be of great interest to federal and state government agencies, educators and schools, public decision makers, research sponsors, regulatory analysts, and scholars.
Download or read book Medicaid Assessment of Variation Among States in Per Enrollee Spending written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-26 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: " Federal Medicaid expenditures totaled about $267 billion in fiscal year 2013. With the expansion of Medicaid under the Patient Protection and Affordable Care Act and rising health care costs, the Congressional Budget Office projects that such expenditures will grow to about $576 billion by fiscal year 2024. GAO was asked to examine variation among states in Medicaid spending and factors that influence such spending, and state approaches to setting rates per enrollee for Medicaid managed care plans. This report examines (1) Medicaid spending per enrollee by state; (2) selected factors that influence Medicaid spending per enrollee, by state; and (3) how states account for factors that influence expected per-enrollee spending when setting rates for Medicaid managed care plans. GAO analyzed Medicaid enrollment and combined federal and state expenditure data provided by CMS for fiscal year 2008, and examined illustrative examples of factors that have been reported to influence health care spending, such as age, disability status, and scope of benefits received. GAO used 2008 data because they allowed a comparable view of spending per enrollee and factors that influence spending per enrollee-as 2008 was the most recent year for which certain data on factors influencing spending were readily available.
Download or read book Recommendations to the Congress written by United States. Congress. Pepper Commission and published by . This book was released on 1990 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Clinical Informatics Study Guide written by John T. Finnell and published by Springer Nature. This book was released on 2022-04-22 with total page 427 pages. Available in PDF, EPUB and Kindle. Book excerpt: This completely updated study guide textbook is written to support the formal training required to become certified in clinical informatics. The content has been extensively overhauled to introduce and define key concepts using examples drawn from real-world experiences in order to impress upon the reader the core content from the field of clinical informatics. The book groups chapters based on the major foci of the core content: health care delivery and policy; clinical decision-making; information science and systems; data management and analytics; leadership and managing teams; and professionalism. The chapters do not need to be read or taught in order, although the suggested order is consistent with how the editors have structured their curricula over the years. Clinical Informatics Study Guide: Text and Review serves as a reference for those seeking to study for a certifying examination independently or periodically reference while in practice. This includes physicians studying for board examination in clinical informatics as well as the American Medical Informatics Association (AMIA) health informatics certification. This new edition further refines its place as a roadmap for faculty who wish to go deeper in courses designed for physician fellows or graduate students in a variety of clinically oriented informatics disciplines, such as nursing, dentistry, pharmacy, radiology, health administration and public health.
Download or read book Serving the Congress written by and published by . This book was released on 1991 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Literacy in Nursing written by Terri Ann Parnell and published by Springer Publishing Company. This book was released on 2014-08-18 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: Print+CourseSmart
Download or read book The 1 5 Billion People Question written by Harold Alderman and published by World Bank Publications. This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book addresses the thorny and fascinating question of how food and voucher programs, despite theory and evidence generally favoring cash, remain relevant, have evolved, and, in most circumstances, have improved over time. In doing so, we take an evolutionary and pragmatic view; we are interested in understanding why food-based programs exist and how countries can benefit from transformations such as that of Chhattisgarh, not in determining whether those programs should exist.
Download or read book Macrosocial Determinants of Population Health written by Sandro Galea and published by Springer Science & Business Media. This book was released on 2007-10-24 with total page 491 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explores social factors such as culture, mass media, political systems, and migration that influence public health while systematically considering how we may best study these factors and use our knowledge from this study to guide public health interventions. Throughout, contributors emphasize the potential of population strategies to influence traditional risk factors associated with health and disease. Each section ends with Galea’s integrative chapters, bringing the observations and conclusions from the chapters into clear, usable focus.
Download or read book Transforming the Workforce for Children Birth Through Age 8 written by National Research Council and published by National Academies Press. This book was released on 2015-07-23 with total page 587 pages. Available in PDF, EPUB and Kindle. Book excerpt: Children are already learning at birth, and they develop and learn at a rapid pace in their early years. This provides a critical foundation for lifelong progress, and the adults who provide for the care and the education of young children bear a great responsibility for their health, development, and learning. Despite the fact that they share the same objective - to nurture young children and secure their future success - the various practitioners who contribute to the care and the education of children from birth through age 8 are not acknowledged as a workforce unified by the common knowledge and competencies needed to do their jobs well. Transforming the Workforce for Children Birth Through Age 8 explores the science of child development, particularly looking at implications for the professionals who work with children. This report examines the current capacities and practices of the workforce, the settings in which they work, the policies and infrastructure that set qualifications and provide professional learning, and the government agencies and other funders who support and oversee these systems. This book then makes recommendations to improve the quality of professional practice and the practice environment for care and education professionals. These detailed recommendations create a blueprint for action that builds on a unifying foundation of child development and early learning, shared knowledge and competencies for care and education professionals, and principles for effective professional learning. Young children thrive and learn best when they have secure, positive relationships with adults who are knowledgeable about how to support their development and learning and are responsive to their individual progress. Transforming the Workforce for Children Birth Through Age 8 offers guidance on system changes to improve the quality of professional practice, specific actions to improve professional learning systems and workforce development, and research to continue to build the knowledge base in ways that will directly advance and inform future actions. The recommendations of this book provide an opportunity to improve the quality of the care and the education that children receive, and ultimately improve outcomes for children.
